Figure 4.

Main risk factors for NAFLD development in men and women. For both sexes, obesity, unbalanced dietary regimens and reduced physical activity represent risk factors for NAFLD development and progression. Arrows represent the relative regulation between males (blue) and females (red). Compared to men, obese pre-menopausal women display more subcutaneous than visceral fat and higher insulin sensitivity, leading to reduced adipose tissue lipolysis and FFA delivery to liver; women show limited HGP and DNL. Under an excess of dietary sugars and fats, with respect to men, women have higher insulin sensitivity, inhibit hepatic lipid uptake, HGP and DNL, and promote FAO and lipid export. Although generally women have a lower physical activity than men, when exercised, oxidize more fats due to the increased type I muscle fibers. Abbreviations: DNL, de novo lipogenesis; FAO, fatty acids oxidation; FFA, free fatty acids; HGP, hepatic glucose production.