The dysregulation of hepatic lipid metabolism is one of the hallmarks in many
liver diseases including
alcoholic liver diseases (ALD) and non-
alcoholic fatty liver diseases (
NAFLD). Hepatic
inflammation, lipoperoxidative stress as well as the imbalance between
lipid availability and
lipid disposal, are direct causes of
liver steatosis. The application of
herbal medicines with anti-oxidative stress and
lipid-balancing properties has been extensively attempted as
pharmaceutical intervention for liver disorders in experimental and clinical studies. Although the molecular mechanisms underlying their hepatoprotective effects warrant further exploration, increasing evidence demonstrated that many
herbal medicines are involved in regulating
lipid accumulation processes including hepatic lipolytic and lipogenic pathways, such as mitochondrial and peroxisomal β-oxidation, the secretion of
very low density lipoprotein (VLDL), the non-
esterified fatty acid (
NEFA) uptake, and some vital hepatic lipogenic
enzymes. Therefore, in this review, the pathways or crucial mediators participated in the dysregulation of hepatic lipid metabolism are systematically summarized, followed by the current evidences and advances in the positive impacts of
herbal medicines and natural products on the lipid metabolism pathways are detailed. Furthermore, several herbal formulas, herbs or herbal derivatives, such as Erchen Dection, Danshen,
resveratrol, and
berberine, which have been extensively studied for their promising potential in mediating lipid metabolism, are particularly highlighted in this review.