Pathogenesis and spectrum of MAFLD (IMAGE) Xia & He Publishing Inc. Caption Hepatic steatosis is promoted by factors such as obesity, insulin resistance, de novo lipogenesis, high-calorie diets, genetic factors, and gut microbiome dysbiosis. In contrast, VLDL export, and increased fatty acid oxidation in the initial stages clear the excessively accumulated fat from hepatocytes. However, ongoing hepatic steatosis that exceeds the capacity of the liver to oxidize intracellular lipids in the mitochondria activates alternate oxidation pathways and generates reactive oxygen species, resulting in steatohepatitis. Both fatty liver stage and steatohepatitis can progress to cirrhosis and subsequent hepatocellular carcinoma unless the risk factors are modified. MAFLD, metabolic dysfunction-associated fatty liver disease; VLDL, very low-density lipoproteins. Credit Sandhiya Selvarajan, Pazhanivel Mohan, Jayavardhan Vulchi Usage Restrictions Credit must be given to the creator. Only noncommercial uses of the work are permitted. License CC BY-NC Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.