非酒精性脂肪性肝病（NAFLD）是一种逐渐发展为非酒精性脂肪性肝炎（NASH）、NASH相关的肝硬化和肝细胞癌（HCC）的肝脏疾病。NAFLD从简单脂肪肝（或非酒精性脂肪性肝【NAFL】）到作为NAFL的一种进展形式的NASH，其特征为脂肪变性、小叶性炎症和有或无纤维化的肝细胞肿胀。由于NAFLD的复杂病理生理机制和异质性，包括其广谱的临床和组织学特征，目前尚无特定用于治疗NAFLD的药物获批。NAFLD的异质性与细胞可塑性密切相关，细胞可塑性描述了细胞对环境刺激具有获取新身份或改变表型的能力。肝脏由包括肝细胞和胆管细胞等实质细胞以及包括库普弗细胞、肝星状细胞和内皮细胞等非实质细胞组成，所有这些细胞都具有专门的功能。这种异质性细胞群体具有细胞可塑性以适应环境变化。在NAFLD进展过程中，这些细胞可以在暴露于多种刺激因素，包括脂肪酸、炎症和氧化应激后，在多个层面上产生多样而复杂的反应。因此，本综述通过探讨NAFLD进展过程中肝细胞、胆管细胞、肝星状细胞和库普弗细胞的细胞可塑性和代谢适应，为了解NAFLD的异质性提供洞察力。 Copyright © 2023 Park, Choi, Kim, Yang, An, Lee, Han, Lee, Kim, Bae and Oh.

Nonalcoholic fatty liver disease (NAFLD) is a progressive liver disease that can progress to nonalcoholic steatohepatitis (NASH), NASH-related cirrhosis, and hepatocellular carcinoma (HCC). NAFLD ranges from simple steatosis (or nonalcoholic fatty liver [NAFL]) to NASH as a progressive form of NAFL, which is characterized by steatosis, lobular inflammation, and hepatocellular ballooning with or without fibrosis. Because of the complex pathophysiological mechanism and the heterogeneity of NAFLD, including its wide spectrum of clinical and histological characteristics, no specific therapeutic drugs have been approved for NAFLD. The heterogeneity of NAFLD is closely associated with cellular plasticity, which describes the ability of cells to acquire new identities or change their phenotypes in response to environmental stimuli. The liver consists of parenchymal cells including hepatocytes and cholangiocytes and nonparenchymal cells including Kupffer cells, hepatic stellate cells, and endothelial cells, all of which have specialized functions. This heterogeneous cell population has cellular plasticity to adapt to environmental changes. During NAFLD progression, these cells can exert diverse and complex responses at multiple levels following exposure to a variety of stimuli, including fatty acids, inflammation, and oxidative stress. Therefore, this review provides insights into NAFLD heterogeneity by addressing the cellular plasticity and metabolic adaptation of hepatocytes, cholangiocytes, hepatic stellate cells, and Kupffer cells during NAFLD progression.Copyright © 2023 Park, Choi, Kim, Yang, An, Lee, Han, Lee, Kim, Bae and Oh.