Nonalcoholic Fatty Liver Disease: Focus on New Biomarkers and Lifestyle Interventions

Int J Mol Sci. 2021 Apr 9;22(8):3899. doi: 10.3390/ijms22083899.


Nonalcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome, characterized from pathological changes in lipid and carbohydrate metabolism. Its main characteristics are excessive lipid accumulation and oxidative stress, which create a lipotoxic environment in hepatocytes leading to liver injury. Recently, many studies have focused on the identification of the genetic and epigenetic modifications that also contribute to NAFLD pathogenesis and their prognostic implications. The present review is aimed to discuss on cellular and metabolic alterations associated with NAFLD, which can be helpful to identify new noninvasive biomarkers. The identification of accumulated lipids in the cell membranes, as well as circulating cytokeratins and exosomes, provides new insights in understanding of NAFLD. This review also suggests that lifestyle modifications remain the main prevention and/or treatment for NAFLD.

Keywords: Mediterranean diet; NAFLD; cytokeratins; exosomes; fatty acids; lipid metabolism; physical activity.

Publication types

  • Review

MeSH terms

  • Animals
  • Biomarkers*
  • Cytokines / metabolism
  • Diet
  • Disease Management
  • Disease Susceptibility*
  • Exercise
  • Exosomes
  • Fatty Acids / metabolism
  • Health Behavior
  • Hepatocytes / metabolism
  • Humans
  • Life Style
  • Lipid Metabolism
  • Lipidomics
  • Lipids / blood
  • Microbiota
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Non-alcoholic Fatty Liver Disease / metabolism*


  • Biomarkers
  • Cytokines
  • Fatty Acids
  • Lipids