One shorthand way to understand the process of fat accumulation in the liver - There are two ways that extra fat can get into the liver, and two ways it can go out, and these paths out may not be sufficient to deal with the fat and sugar coming in.
1st Way In: Eating lots of fat without enough nutrients (especially CHOLINE) to process it 2nd Way In: De Novo Lipogenesis - making NEW fat out of sugar because the other cells in the body won't take it
1st Way Out: Make more triglycerides 2nd Way Out: Make more VLDL
When triglycerides and VLDL are elevated and there's STILL fat left in the liver, the input clearly exceeds the liver's ability to get it out.
Non-Alcoholic Fatty Liver Disease and Polycystic Ovary Syndrome are both manifestations of a larger pattern called Metabolic Syndrome. PCOS is more obvious because it can cause infertility or subfertility, while NAFLD causes vague symptoms like fatigue and dull pain in the liver area. Both are treatable through diet and lifestyle modifications, which give more comprehensive results than medications such as metformin.