Fatty liver is increasingly recognized as a central component/consequence of the metabolic syndrome. In this review of the relationship between the metabolic syndrome and fatty liver content, Kotronen and Yki-Järvinen summarize the causes and pathophysiology of fatty liver. The authors also discuss the definition and quantification of steatosis and shed light on the relationship between liver fat and several markers of insulin sensitivity, dyslipidemia, and inflammation. With respect to fatty liver, intra-abdominal fat (visceral) accumulation, poor nutritional habits, and lack of physical activity are key factors responsible for this clinical phenotype. The article also summarizes the findings of intervention studies that targeted fatty liver through weight loss, diet, exercise, and pharmacological interventions with either PPARg agonists or insulin. In their conclusion, the authors stress that further research is needed on how to decrease liver fat without necessarily affecting body weight. They also call attention to the need to identify genetic factors associated with fatty liver.
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