Hormonal
Insulin resistance drives nonalcoholic fatty liver disease (NAFLD) progression through increased free fatty acid flux from adipose tissue to the liver, leading to hepatic triglyceride accumulation and impaired glucose metabolism.
Fatty liver is fundamentally a metabolic disorder driven by insulin resistance, not just a result of eating too much fat or sugar. Even lean people can develop it. Treating the underlying insulin resistance (e.g., through exercise, weight management, or medication) is key to managing the liver disease, rather than just focusing on liver-specific diets.
Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver.
Why this rating
The paper is a comprehensive review citing multiple studies using gold-standard methods like the euglycemic clamp.
Source
Insulin Resistance: A Metabolic Pathway to Chronic Liver Disease *
Elisabetta Bugianesi et al. · Hepatology · 2005
DOI 10.1002/hep.20920
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