Abstract
Nonalcoholic steatohepatitis (NASH) is a pathological condition characterized by macrovesicular steatosis, necroinflammation, loss of hepatocytes and fibrosis. NASH is often associated with type 2 diabetes mellitus, hypertension, hyperlipoproteinemia and obesity. Recent studies emphasize the role of insulin resistance, oxidative stress and subsequent lipid peroxidation, proinflammatory cytokines, adipokines and mitochondrial dysfunction in the development and progression of NASH. In this article, we will review the role of insulin resistance, oxidative stress and subsequent lipid peroxidation, mitochondrial dysfunction, proinflammatory cytokines, adipokines such as resistin, leptin, adiponectin and PPAR-α, apoptosis, NF kappa B, SREBP-1c, endotoxaemia, and iron overload in the pathogenesis of NASH. The pathogenesis of NASH is thought to be related mainly with insulin resistance and oxidative stress and subsequent lipid peroxidation. Adipocytokines also play an important role in the pathogenesis of NASH through complex and interactive paracrine and endocrine mechanisms. Understanding of the mechanisms responsible for the pathogenesis of NASH has important implications for the treatment of NASH.
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