-We have shown that oxidative stress is a mechanism of free fatty acid (FFA)-induced -cell dysfunction. Unsaturated fatty acids in membranes, including plasma and mitochondrial membranes, are substrates for lipid peroxidation, and lipid peroxidation products are known to cause impaired insulin secretion. Therefore, we hypothesized that mice overexpressing glutathione peroxidase-4 (GPx4), an enzyme that specifically reduces lipid peroxides, are protected from fat-induced -cell dysfunction. GPx4-overexpressing mice and their wild-type littermate controls were infused intravenously with saline or oleate for 48 h, after which reactive oxygen species (ROS) were imaged, using dihydrodichlorofluorescein diacetate in isolated islets, and -cell function was assessed ex vivo in isolated islets and in vivo during hyperglycemic clamps. Forty-eight-hour FFA elevation in wild-type mice increased ROS and the lipid peroxidation product malondialdehyde and impaired -cell function ex vivo in isolated islets and in vivo, as assessed by decreased disposition index. Also, islets of wild-type mice exposed to oleate for 48 h had increased ROS and lipid peroxides and decreased -cell function. In contrast, GPx4-overexpressing mice showed no FFA-induced increase in ROS and lipid peroxidation and were protected from the FFA-induced impairment of -cell function assessed in vitro, ex vivo and in vivo. These results implicate lipid peroxidation in FFA-induced -cell dysfunction. oxidative stress; lipid peroxide; glutathione peroxidase 4; lipotoxicity; -cell dysfunction; in vivo CHRONIC EXPOSURE of pancreatic -cells to free fatty acids (FFA) impairs -cell function (21). Although not all studies are concordant (45), a growing body of evidence implicates oxidative stress as a mechanism of FFA-induced -cell dysfunction (9,38,46,60,67). Pancreatic -cells have low antioxidant defenses (34) and are thus susceptible to reactive oxygen species (ROS)-induced decrease in function and viability (37,47). We have demonstrated previously that 1) prolonged elevation of plasma FFA in rats impairs glucose-stimulated insulin secretion (GSIS) in vivo during hyperglycemic clamps and ex vivo in freshly isolated islets and 2) the treatment with the antioxidants N-acetylcysteine, taurine, or tempol, which decreases islet ROS measured with dihydrodichlorofluorescein diacetate (H 2 DCF-DA), prevents the impairing effects of FFA on -cell function (51). Zhang et al. (72) confirmed our findings in rats (51) in a different model of prolonged FFA elevation. Our group has also shown that the antioxidant taurine alleviates FFA-induced impairment in -cell function in humans (68).The type and cellular localization of ROS in FFA-induced -cell dysfunction are still unclear. We have demonstrated that cytosolic superoxide plays a causal role in fat-induced -cell dysfunction (32); however, since the antioxidants N-acetylcysteine and taurine, which do not decrease superoxide, were also effective in restoring -cell function (51), other ROS are implicated in addition ...