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FFAs are responsible for reduced insulin clearance (37)—hence the moderate hyperinsulinemia observed during the clamp in NAFLD as well as in type 2 diabetic patients (38). In the present big plump women study, FFA levels were not systematically associated with overweightness or central fat accumulation, which are involved in lipid deposition in the hepatic parenchyma (38,39) via increased lipolysis and high visceral fat turnover. big plump women In addition, there was big plump women no correlation between the degree of hepatic steatosis, documented by liver biopsy, and FFA levels. A striking lipid abnormality in NAFLD patients was the lower-than-normal decrease of plasma FFAs in response to insulin infusion, which suggested a decreased insulin-mediated suppression of lipolysis. Whether this defect is the cause or an effect of hepatic lipid deposition remains to be determined. Further studies would also clarify the role of FFA metabolism on decreased insulin sensitivity. The possibility remains that hepatic fat deposition derives from the combined effects of an unknown, genetic combination responsible for reduced insulin sensitivity and acquired conditions (namely, central obesity and increased visceral fat turnover) (40).
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