Review Article

OSAS-Related Inflammatory Mechanisms of Liver Injury in Nonalcoholic Fatty Liver Disease

Table 1

Molecular targets and biological effects of hypoxia inducible factors (HIFs) in the liver.

CellMolecular targetBiological effect

HIF1α
Hepatocyte↑ Lipid droplet binding protein adipose 
differentiation-related protein (ADFP)
↑ Triglyceride storage in lipid droplets [60]
↑ Stearoyl-coenzyme A desaturase 1 (SCD-1)↑ De novo lipogenesis [61]
↑ Enolase 1 
↑ Lactate dehydrogenase 1
↑ Glycolysis 
↑ Pyruvate metabolism [62]
↑ Membrane glucose transporter- (GLUT-) 1 and GLUT-3↑ Glucose uptake [63]
↑ Plasminogen activator inhibitor- (PAI-) 1 
↑ Platelet-derived growth factor- (PDGF-) A and PDGF-B
↑ Hepatic stellate cell activation and fibrogenesis [64]
Hepatic stellate cells↑ PDGF-B 
↑ Transforming growth factor- (TGF-) β1 
↑ Vascular endothelial growth factor (VEGF)  
↑ Chemokine receptor- (CCR-) 1 and 5
↑ Fibrogenesis 
↑ Angiogenesis 
↑ Carcinogenesis [31]
Kupffer cells↑ Plasminogen activator inhibitor- (PAI-) 1 
↑ Platelet-derived growth factor- (PDGF-) A and PDGF-B
↑ Hepatic stellate cell activation and fibrogenesis [65]

HIF2α
Hepatocyte↑ Lipid droplet binding protein adipose 
differentiation-related protein (ADFP)
↑ Triglyceride storage in lipid droplets [62]
↓ Acyl-coenzyme A synthase long-chain family member 1 
↓ Carnitine-palmitoyltransferase I
↓ Mitochondrial fatty acid β-oxidation [62]
↓ Acyl-CoA oxidase (Aco)  
↓ Carnitine O-octanyltransferase
↓ Peroxisomal fatty acid β-oxidation [62]
↑ Membrane fatty acid transporter cluster differentiation 36 (CD36)↑ Fatty acid uptake from plasma [30]
Sterol-regulatory-element binding protein-1c (Srebp-1c)  
Fatty acid synthase (Fas)  
Acetyl-CoA carboxylase (Acc)  
(↑ early after HIF2α activation and then 
↓ after long-term HIF2α activation)
De novo lipogenesis 
(↑ early after HIF2α activation and then 
↓ after long-term HIF2α activation) [30, 62]
↑ Angiopoietin-like 3 (Angptl3)↓ Tissue lipoprotein lipase activity 
↓ 
↑ Plasma triglycerides [62, 66]
↓ Phosphoenolpyruvate-carboxykinase (Pepck)  
↓ Glucose-6-phosphatase
↓ Gluconeogenesis [62, 67]
↓ Peroxisome proliferator-activated receptor γ
coactivator 1α (Pgc-1α)  
↓ Hepatocyte nuclear factor 4 (Hnf4)
↓ Gluconeogenesis [62, 67]  
↓ Mitochondrial fatty acid β-oxidation [62]
↑ Interleukin-1β
↑ Interleukin-6
↑ Inflammation [30]
Macrophage↑ Interleukin-1β
↑ Interleukin-6
↑ Inflammation [30]
Hepatic stellate cells↑ Lysyl oxidase-like- (LOXL-) 1 and LOXL-2 
↑ Prolyl 4-hydroxylase α- (P4HA-) 1 and P4HA-2 
↑ Procollagen lysine
↑ 2-Oxoglutarate 5-dioxygenase 2 (PLOD2)  
↑ Transglutaminase 2 (TGM2)
↑ Collagen synthesis and deposition 
↑ Fibrogenesis [30]