Fig. 1

Potential contributors to NAFLD in lean individuals. Despite the same pathological findings in the liver, the factors that contribute to NAFLD and subsequent progression NASH in lean individuals are not yet well-characterized relative to those with obesity-related NAFLD. However, a number of factors that likely influence risk of NAFLD development and progression, even in the absence of excess adiposity, have been postulated in the recent literature. The majority of these risk factors fall into environmental, endocrine, genetic, and metabolic origins. Most of these factors are also expected to interact with one another, as well as other, as-yet-undefined factors, to further modulate NAFLD risk