Table 2.

Major events in the liver contributing to nonalcoholic fatty liver disease (NAFLD).

Outcome	Causes
Increased influx of the circulating free fatty acids (FFA)	Obesity
	Overfeeding (also saturated fatty acids)
	Rapid weight loss
	Total parenteral nutrition (transformation of carbohydrates/proteins to TG)
Decreased mitochondrial β-oxidation of FFA	Vitamin B5 (pantothenic acid) deficiency
	Excessive alcohol consumption
	Drugs: valproic acid or chronic aspirin → coenzyme A deficiency
	Decreased activity acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1)
	Possible decreased activity of miRNAs
	Increased accumulation of ceramides
Decreased secretion/export of very low-density lipoproteins (VLDL)	Abetalipoproteinemia, protein malnutrition, or choline deficiency
	Defective secretion of postprandial Apo B
	Drugs: amiodarone and tetracycline → defective lipidation of Apo B (inhibition of microsomal triglyceride transfer protein (MTP))
	Ongoing NAFLD/NASH