Purpose of review: A net retention of triacylglycerol within the liver is a prerequisite for the development of nonalcoholic fatty liver disease. The accumulation of liver fat reflects an imbalance between fatty acid input and disposal. Here we summarize recent research into understanding the fate of fatty acids within the hepatocyte.
Recent findings: Several recent studies have elucidated the contribution of different sources of fatty acids to liver fat and to plasma triacylglycerol. Some recent studies have suggested that, contrary to expectations, hepatic fatty acid oxidation is upregulated in insulin-resistant individuals. A recent observation shows the potential importance of fatty acid transformation, especially desaturation, to determination of metabolic fate. These studies highlight our lack of understanding of the regulation of metabolic partitioning of fatty acids within the human liver.
Summary: The regulation of hepatic fatty acid partitioning involves many factors; not least insulin. Insulin undoubtedly regulates the supply of fatty acids to the liver from adipose tissue; however, whether insulin has a direct intrahepatic effect on hepatic fatty acid partitioning, in humans, remains unclear. The transformation of fatty acids, by desaturases, may have an important role in aiding the disposal of saturated fatty acids via oxidative pathways. Factors that upregulate hepatic fatty acid oxidation need to be elucidated.