Nonalcoholic fatty liver disease(NAFLD),a chronic liver disease in which fat accumulates in the liver and is associated with metabolic dysfunction in the form of obesity and insulin resistance,has become the most common liver disease in China.Fatty acid metabolism in the liver is regulated by a combination of fatty acid uptake and output,de novo lipogenesis and fatty acid β-oxidation.This article reviews the molecular mechanisms underly-ing abnormal hepatic fatty acid metabolism in NAFLD,focusing on several major pathways of hepatic lipid homeo-stasis imbalance.In NAFLD,the balance of fatty acid acquisition and depletion is disrupted,hepatic fatty acid up-take and fatty acid synthesis from scratch are increased,mitochondrial function is impaired,peroxisomal and cyto-chrome fatty acid oxidation is increased,VLDL output is increased,and compensatory enhancement of fatty acid ox-idation and output is insufficient to return fatty acid levels to normal,and hepatic fatty acid accumulation begins.Dysregulation of fatty acid homeostasis in hepatocytes results in the production of toxic lipids,which further induces oxidative stress and lipotoxicity to promote organelle dysfunction,apoptosis and disease progression.
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