As we shall discuss, PPC may help correct steatosis. Fatty liver as a longstanding chronic condition can occur in association with a wide range of diseases, toxins and drugs, although in clinical practice, the majority of cases are due to alcohol excess, diabetes and obesity. Much less common are occurrences of acute fatty liver during pregnancy and as a response to administration of tetracyclines, acetaminophen and other drugs and toxins. Fatty liver had long been believed to be a benign reversible condition. Cirrhosis is the irreversible end result of fibrous scarring, a response of the liver to a variety of long-standing inflammatory, toxic, metabolic and congestive damage.
Alcohol is by far the commonest cause both of steatosis and cirrhosis in the Western world.
However, there is a considerable inter-individual difference in the degree of liver damage produced by excessive alcohol intake. There seem to be no clear correlations between the incidence and severity of fatty liver and either the amount, type or duration of alcohol abuse. It has been unclear why in some individuals steatosis, whatever its etiology, never progresses to steatohepatitis and cirrhosis. A growing body of evidence suggests that the oxidation of fat in the liver leads to the development of liver damage, and free radicals have been demonstrated to play an important role in the hepatotoxic effect of many substances. The oxidation of fats takes place through a chain reaction called lipid peroxidation that impairs the anatomical and functional integrity of membranes and creates new toxic substances that further extend the damage.