Obesity plays a crucial role in the development of non-alcoholic fatty liver disease (NAFLD). However

the underlying mechanism for the pathogenesis of obesity-associated NAFLD remains largely obscure. Although the “multiple hit” theory provides a more accurate explanation of NAFLD pathogenesis

it still cannot fully explain precisely how obesity causes NAFLD. The liver is the key integrator of the body's energy needs

receiving input from multiple metabolically active organs. Thus

recent studies have advocated the “multiple crosstalk” hypothesis

highlighting that obesity-related hepatic steatosis may be the result of dysregulated “crosstalk” among multiple extra-hepatic organs and the liver in obesity. A wide variety of circulating endocrine hormones work together to orchestrate this “crosstalk”. Of note

with deepening understanding of the endocrine system

the perception of hormones has gradually risen from the narrow sense (i.e. traditional hormones) to the broad sense of hormones as organokines and exosomes. In this review

we focus on the perspective of organic endocrine hormones (organokines) and molecular endocrine hormones (exosomes)

summarizing systematically how the two types of new hormones mediate the dialogue between extra-hepatic organs and liver in the pathogenesis of obesity-related NAFLD.