Norbert Stefan,
Konstantinos Kantartzis and
Hans-Ulrich Häring
Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University of Tübingen, D-72076 Tübingen, Germany
Correspondence: Address all correspondence and requests for reprints to: Hans-Ulrich Häring, M.D., Department of Internal Medicine, Otfried-Müller-Strasse 10, D-72076 Tübingen, Germany. E-mail: Hans-Ulrich.Haering{at}med.uni-tuebingen.de
Type 2 diabetes and cardiovascular disease represent a seriousthreat to the health of the population worldwide. Although overalladiposity and particularly visceral adiposity are establishedrisk factors for these diseases, in the recent years fatty liveremerged as an additional and independent factor. However, thepathophysiology of fat accumulation in the liver and the cross-talkof fatty liver with other tissues involved in metabolism inhumans are not fully understood. Here we discuss the mechanismsinvolved in the pathogenesis of hepatic fat accumulation, particularlythe roles of body fat distribution, nutrition, exercise, genetics,and gene-environment interaction. Furthermore, the effects offatty liver on glucose and lipid metabolism, specifically viainduction of subclinical inflammation and secretion of humoralfactors, are highlighted. Finally, new aspects regarding thedissociation of fatty liver and insulin resistance are addressed.
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