Non‐alcoholic fatty liver disease as a consequence of autonomic imbalance and circadian desynchronization

Summary The circadian system, headed by the suprachiasmatic nucleus, synchronizes behaviour and metabolism according to the external light–dark cycle through neuroendocrine and autonomic signals. Metabolic diseases, such as steatosis, obesity and glucose intolerance, have been associated with conditions of circadian misalignment wherein the feeding schedule has been moved to the resting phase. Here we describe the physiological processes involved in liver lipid accumulation and show how they follow a circadian pattern importantly regulated by both the autonomic nervous system and the feeding–fasting cycle. We propose that an unbalanced activity of the sympathetic–parasympathetic branches between organs induced by circadian misalignment provides the conditions for the development and progression of non‐alcoholic fatty liver disease.