Comprehensive study and triggering factors of alcoholic and non-alcoholic fatty liver

Year : 2026 | Volume : 16 | 01 | Page :
    By

    Manpreet Singh,

  • Pankaj Malhotra,

  1. Student, Department of Pharmacy, School of Health Sciences, Sushant University, Gurugram, Haryana, India
  2. Assistant Professor, Department of Pharmacy, School of Health Sciences, Sushant University, Gurugram, Haryana, India

Abstract

Over the past few years, fatty liver disease has turned out to be a rather widespread phenomenon and has become a serious issue with the global population nowadays. It comprises alcoholic fatty liver disease and non-alcoholic fatty liver disease, which develop under the influence of various initiating factors, though frequently follow similar pathologies. The overloading of lipids in the hepatocytes in most cases will be the first sign of the disease, which may progress further to inflammation, fibrosis, and cirrhosis in case the culprits are not removed. In this review, emphasis of investigation has been laid on the key biological and lifestyle issues which provoke the onset of fatty liver disease. Genetic pre-disposition, resistance to insulin, and impaired lipid metabolism denote a significant contribution to the role of enhancing hepatic fat accretion. Moreover, oxidative stress and inflammatory reactions provide the factors of hepatocellular destruction and promote the course of the disease. Other lifestyle choices include chronic alcohol consumption, poor nutrition, physical sedentary behaviors, being overweight, psychological stress, smoking exacerbate liver damage and are significant sources of disease severity. It is worth noting that fatty liver disease usually goes unnoticed in its initial stages where the conditions can be reversed. The understanding of the interacting risk factors about alcoholic and non-alcoholic fatty liver disease could be enhanced, which could aid in an early intervention measure and help mitigate the long-term liver-related complications.

Keywords: Liver disease, smoking, non-alcoholic fatty liver, lipid metabolism, fibrosis, inflammation

How to cite this article:
Manpreet Singh, Pankaj Malhotra. Comprehensive study and triggering factors of alcoholic and non-alcoholic fatty liver. Research and Reviews: A Journal of Pharmacology. 2026; 16(01):-.
How to cite this URL:
Manpreet Singh, Pankaj Malhotra. Comprehensive study and triggering factors of alcoholic and non-alcoholic fatty liver. Research and Reviews: A Journal of Pharmacology. 2026; 16(01):-. Available from: https://journals.stmjournals.com/rrjop/article=2026/view=237360


References

  1. Sharma A, Nagalli S. Chronic liver disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
  2. Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD. Nat Med. 2018;24(7):908–922.
  3. Younossi ZM, et al. Global epidemiology of NAFLD. Hepatology. 2016;64(1):73–84.
  4. Tilg H, Moschen AR, Roden M. NAFLD and diabetes. Nat Rev Gastroenterol Hepatol. 2017;14(1):32–42.
  5. Marchesini G, et al. NAFLD and metabolic syndrome. Hepatology. 2003;37(4):917–923.
  6. Gao B, Bataller R. Alcoholic liver disease pathogenesis. Gastroenterology. 2011;141(5):1572–1585.
  7. Allameh A, et al. Oxidative stress in liver disease. Antioxidants (Basel). 2023;12(2):1–25.
  8. Parola M, Robino G. Oxidative stress and fibrosis. J Hepatol. 2001;35(2):297–306.
  9. Friedman SL. Hepatic fibrogenesis. Gastroenterology. 2008;134(6):1655–1669.
  10. Anstee QM, et al. Genetics of fatty liver disease. Gastroenterology. 2016;150(7):1668–1682.
  11. Malhotra P, Minocha N, Pandey P, Kaushik D, Vashist N. A review on history, chemical constituents, phytochemistry, pharmacological activities, and recent patents of Valerian. The Natural Products Journal. 2024 Mar 1;14(2):98-106.Fabbrini E, et al. Obesity and NAFLD. Hepatology. 2010;51(2):679–689.
  12. Musso G, et al. Diet and NAFLD. Am J Clin Nutr. 2010;91(5):1282–1290.
  13. Lieber CS. Alcohol and nutrition. Alcohol Res Health. 2003;27(3):220–231.
  14. Romero-Gomez M, et al. NAFLD management. J Hepatol. 2017;67(4):829–846.
  15. Shankar D, Mishra D, Singh A, Pathak N, Minocha N, Pandey P, Malhotra P. Revolutionizing Disease Prevention: The Rise of mRNA Vaccines and Nanotechnology for the Treatment of Cancer and Infectious Diseases. Current Nanomedicine. 2025 Feb 18.Hallsworth K, Adams LA. Lifestyle therapy in NAFLD. JHEP Rep. 2019;1(2):79–89.
  16. El-Zayadi AR. Smoking and liver disease. World J Gastroenterol. 2006;12(38):6098–6101.
  17. Jung HS, et al. Smoking and NAFLD. Am J Gastroenterol. 2019;114(3):453–463.
  18. Ajmera VH, et al. Alcohol use in NAFLD. Clin Gastroenterol Hepatol. 2022;20(6):1260–1272.
  19. Gupta T, Malhotra P. The Role of Pyruvate Dehydrogenase in Non-Alcoholic Fatty Liver Disease: Therapeutic Insights and Future Directions. Research & Reviews: A Journal of Pharmacology. 2024 Sep 27;14(3):44-51.Chalasani N, et al. NAFLD practice guidelines. Hepatology. 2018;67(1):328–357.
  20. Vilar-Gomez E, et al. Weight loss and NASH. Gastroenterology. 2015;149(2):367–378.
  21. Marchesini G, et al. Diet and fatty liver. J Hepatol. 2016;65(4):811–820.
  22. Younossi ZM. NAFLD as public health issue. J Hepatol. 2019;70(3):531–544.
  23. European Association for the Study of the Liver. EASL clinical practice guidelines: NAFLD. J Hepatol. 2016;64(6):1388–1402.
  24. World Health Organization. Global status report on alcohol and health. Geneva: WHO; 2018.
  25. Begriche K, et al. Mitochondrial dysfunction in NAFLD. J Hepatol. 2013;58(1):89–99.
  26. Cusi K. Insulin resistance in NAFLD. Gastroenterology. 2012;142(4):711–725.
  27. Sanyal AJ. NASH pathogenesis. Clin Liver Dis. 2005;9(4):659–676.
  28. Browning JD, Horton JD. Hepatic steatosis mechanisms. J Clin Invest. 2004;114(2):147–152.
  29. Gupta T, Malhotra P. The Role of Pyruvate Dehydrogenase in Non-Alcoholic Fatty Liver Disease: Therapeutic Insights and Future Directions. Research & Reviews: A Journal of Pharmacology. 2024 Sep 27;14(3):44-51.Lonardo A, et al. NAFLD and cardiovascular disease. Dig Liver Dis. 2015;47(1):4–11.
  30. Tilg H, Moschen AR. Inflammation in NAFLD. J Hepatol. 2010;52(2):183–186.
  31. Targher G, Byrne CD. Metabolic syndrome and NAFLD. Diabetes Metab. 2013;39(4):274–284.
  32. Mendez-Sanchez N, et al. NAFLD treatment. Ann Hepatol. 2010;9(4):326–333.
  33. Schuppan D, Kim YO. Liver fibrosis therapies. J Clin Invest. 2013;123(5):1887–1901.
  34. Stickel F, Hampe J. Genetics of alcoholic liver disease. Gut. 2012;61(10):150–164.
  35. Mathurin P, Bataller R. Trends in alcoholic liver disease. Nat Rev Gastroenterol Hepatol. 2015;12(5):231–242.
  36. Samuel VT, Shulman GI. Insulin resistance mechanisms. Cell. 2012;148(5):852–871.
  37. Lee YH, et al. Sarcopenia and NAFLD. Hepatology. 2016;63(2):607–618.
  38. Friedman SL, Pinzani M. Liver fibrosis. N Engl J Med. 2022;386(4):347–356.
  39. Mantovani A, Byrne CD. NAFLD and inflammation. Metabolism. 2018;82:92–101.
  40. Loomba R, Sanyal AJ. NAFLD epidemic. Nat Rev Gastroenterol Hepatol. 2013;10(11):686–690.
  41. Buzzetti E, et al. NAFLD progression. Nat Rev Gastroenterol Hepatol. 2016;13(4):196–205.
  42. Begriche K, et al. Oxidative stress pathways. Redox Biol. 2015;4:160–172.
  43. Albano E. Alcohol-induced oxidative stress. Mol Aspects Med. 2008;29(1–2):9–16.
  44. Tsukamoto H. Alcoholic liver injury mechanisms. Alcohol Res. 2016;38(2):219–230.
  45. Yilmaz Y. NAFLD fibrosis progression. Clin Gastroenterol Hepatol. 2014;12(3):460–468.
  46. Pais R, et al. Natural history of NAFLD. J Hepatol. 2013;59(1):73–80.
  47. Kleiner DE, et al. Histological scoring system for NAFLD. Hepatology. 2005;41(6):1313–1321.
  48. Wong VW, et al. Fibrosis in NAFLD. Gastroenterology. 2010;138(6):2241–2250.
  49. Caldwell SH, et al. Obesity and liver injury. Hepatology. 1999;29(4):1134–1138.
  50. Tiniakos DG, et al. Steatohepatitis pathology. Semin Liver Dis. 2010;30(2):99–112.
  51. Chalasani NP, et al. Drug-induced liver injury. Gastroenterology. 2015;148(7):1340–1352.
  52. Stickel F, et al. Nutrition in liver disease. J Hepatol. 2020;72(4):840–858.
  53. Dunn W, et al. NAFLD epidemiology. Am J Gastroenterol. 2008;103(9):2263–2271.
  54. Bugianesi E, et al. Insulin resistance and NASH. Hepatology. 2005;42(2):253–261.
  55. Sookoian S, Pirola CJ. Genetics of NAFLD. Clin Sci (Lond). 2011;121(6):253–264.
  56. Romeo S, et al. PNPLA3 polymorphism. Nat Genet. 2008;40(12):1461–1465.
  57. Speliotes EK, et al. Genetic susceptibility to NAFLD. Nat Genet. 2011;43(10):1000–1004.
  58. Anstee QM, et al. Genetic modifiers of NAFLD. J Hepatol. 2015;62(1):203–215.
  59. Chalasani N, et al. Clinical NAFLD update. Gastroenterology. 2020;158(6):1611–1625.
  60. Dyson JK, et al. NAFLD diagnosis. Lancet Gastroenterol Hepatol. 2018;3(7):475–485.
  61. Loomba R, et al. Imaging NAFLD. Hepatology. 2017;66(1):345–357.
  62. Eslam M, et al. MAFLD concept. Nat Rev Gastroenterol Hepatol. 2020;17(5):297–311.
  63. Byrne CD, Targher G. NAFLD and diabetes. Nat Rev Endocrinol. 2015;11(2):93–103.
  64. Stefan N, et al. Fatty liver and insulin resistance. Lancet Diabetes Endocrinol. 2013;1(1):65–76.
  65. Koliaki C, et al. Metabolic pathways in NAFLD. Nat Rev Endocrinol. 2020;16(7):345–362.
  66. Tarantino G, et al. Inflammation and NAFLD. World J Gastroenterol. 2013;19(34):5797–5808.
  67. Seki E, et al. Immune pathways in liver disease. Nat Rev Immunol. 2012;12(6):415–430.
  68. Tacke F. Targeting inflammation. J Hepatol. 2017;66(5):1066–1078.
  69. Bataller R, Brenner DA. Liver fibrosis mechanisms. J Clin Invest. 2005;115(2):209–218.
  70. Mathurin P, et al. Alcohol abstinence outcomes. Gastroenterology. 2011;140(5):159–168.
  71. Addolorato G, et al. Alcohol dependence and liver disease. Lancet. 2018;392(10152):245–256.
  72. Mann RE, et al. Alcohol policy impact. Lancet Public Health. 2017;2(5):e234–e243.
  73. Dunn W, Schwimmer JB. Pediatric NAFLD. Hepatology. 2008;48(5):1696–1704.
  74. Schwimmer JB, et al. NAFLD in youth. Gastroenterology. 2006;130(5):1380–1388.
  75. Lavine JE, et al. Pediatric NAFLD guidelines. Hepatology. 2011;54(3):1197–1206.
  76. Brunt EM. NASH histology. Semin Liver Dis. 2004;24(1):3–20.
  77. Promrat K, et al. Exercise intervention in NAFLD. Hepatology. 2010;51(1):121–129.
  78. Zelber-Sagi S, et al. Physical activity and NAFLD. J Hepatol. 2008;48(6):1017–1023.
  79. Mellinger JL, Volk ML. Liver disease prevention. Clin Gastroenterol Hepatol. 2018;16(11):1669–1676.
Ahead of Print Subscription Review Article
Volume 16
01
Received 15/02/2026
Accepted 21/02/2026
Published 22/02/2026
Publication Time 7 Days
89

Login


My IP

PlumX Metrics