NASH is a serious form of nonalcoholic fatty liver disease (often abbreviated as NAFLD) and is the liver manifestation of metabolic syndrome, a constellation of disorders that includes insulin resistance, persistently elevated insulin levels, Type 2 diabetes and obesity. Excessive caloric intake and a sedentary lifestyle can result in a state of overnutrition and drive pathological metabolic processes in the liver that significantly contribute to the onset of NASH. In a state of overnutrition, one of the cell’s important energy sources called pyruvate rapidly enters the mitochondria of cells via the mitochondrial pyruvate carrier (MPC), leading to the modification of multiple downstream pathways and functions in the liver’s cells. The effects of these processes include insulin resistance, further increases in fasting plasma insulin, increased fat storage, decreased fat oxidation, inflammation, cell damage and scarring, or fibrosis. Over time, fibrosis in liver cells may lead to cirrhosis, and ultimately, such diminished liver function may require a liver transplant or lead to liver cancer, and potentially, liver-related death.