Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1099
Peer-review started: May 27, 2014
First decision: June 27, 2014
Revised: July 11, 2014
Accepted: September 5, 2014
Article in press: September 5, 2014
Published online: January 28, 2015
Core tip: The aldose reductase (AR)/polyol pathway has recently been reported to be involved in the development of fatty liver disease (FLD) via various pathways. Some isoflavones have been reported to be potent AR inhibitors. Here, we review the anti-FLD actions of isoflavones and the proposed mechanism whereby isoflavones protect against FLD, with regard to the AR/polyol pathway. We propose that isoflavones block the AR/polyol pathway to suppress fructose production in the liver, improve peroxisome-proliferator-activated-receptor-α-mediated fatty acid oxidation, ameliorate cytochrome-P450-2E1-mediated oxidative stress, and attenuate AR/gut bacterial endotoxin-mediated cytokine overproduction, which in turn alleviates the progression of FLD.