NAFLD and Cardiometabolic Risk Factors: The Liver Fibrosis Trajectory Through the Lens of Biological Interactions.

Nonalcoholic fatty liver disease (NAFLD) often co-occurs with one or more cardiometabolic risk factors (1) which are shared with NAFLD-associated fibrosis, suggesting that multiple etiologic pathways are involved in the disease biology (2). As hepatic steatosis and cardiometabolic traits shape one another (1), this interrelationship drives multiple burdens of predisposing conditions, making it difficult to discriminate the extent and determinants of progression to severe liver disease. As a result, the role of steatosis in predisposing an individual to liver fibrosis in the context of multiple and concomitant risk factors has not been adequately studied.