This article is available online at http://www.jlr.org mainly as neutral lipids consisting of triacylglycerols, cholesterol esters, and diacylglycerols. NAFLD ranges in severity from benign hepatosteatosis to nonalcoholic steatohepatitis (NASH) ( 1 ). NASH is defi ned as hepatosteatosis with infl ammation and hepatic injury ( 2 ). Although simple hepatosteatosis is considered clinically benign, NASH is the progressive form of the disease that can lead to significant changes in hepatic morphology (hepatocyte ballooning) and injury (cell death and fi brosis).The incidence of NAFLD has increased in parallel with the obesity epidemic in Western societies. In the general population, the prevalence of NAFLD is estimated to range from 6 to 33% ( 3 ), and ف 30-40% of individuals with hepatic steatosis progress to NASH ( 4 ). The prevalence of NASH ranges from 3 to 5% in the general population ( 3 ). NAFLD and NASH have high prevalence ( у 60%) in patients with type 2 diabetes ( 5 ). Additionally, NASH patients have higher mortality rates than NAFLD patients ( 6-8 ), and over a 10 year period, cirrhosis and liver-related death occurs in 20 and 12% of NASH patients, respectively ( 9 ). Because NASH can progress to cirrhosis, hepatocellular cancer, and liver failure ( 4,(10)(11)(12)(13)(14), it is the third most common cause for liver transplantation. NASH is projected to be the leading cause of liver transplantation in the United States by 2020 ( 15 ).Hepatic fi brosis involves the increased production of extracellular matrix (ECM) from activated hepatic stellate cells and myofi broblasts infi ltrating the liver. The liver has an underlayment of connective tissue composed of several Nonalcoholic fatty liver disease (NAFLD) is a signifi cant public health burden in Western societies. NAFLD is defi ned as excess accumulation of liver fat (hepatosteatosis),