Hormonal
Uric acid induces hepatic steatosis by generating mitochondrial oxidative stress, which inhibits aconitase, leading to citrate accumulation and subsequent de novo lipogenesis.
High fructose intake generates uric acid in the liver, which causes oxidative stress and fat accumulation. Lowering uric acid (e.g., via allopurinol in hyperuricemic patients) can reduce liver fat. For the general population, reducing fructose/sugar intake may prevent this uric acid-mediated pathway.
Mitochondrial oxidative stress results in the inhibition of aconitase in the Krebs cycle, resulting in the accumulation of citrate and the stimulation of ATP citrate lyase and fatty-acid synthase leading to de novo lipogeneis.
Why this rating
Strong mechanistic evidence in cell lines and animal models, supported by human observational data, but lacks direct human interventional trials proving causality in healthy populations.
Source
Uric Acid Induces Hepatic Steatosis by Generation of Mitochondrial Oxidative Stress
Miguel A. Lanaspa et al. · Journal of Biological Chemistry · 2012
DOI 10.1074/jbc.m112.399899
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