FoxO transcription factors have been implicated in lipid metabolism; however, the underlying mechanisms are not well understood. Here, in an effort to elucidate such mechanisms, we examined the phenotypic consequences of liver-specific deletion of three members of the FoxO family: FoxO1, FoxO3, and FoxO4. These liver-specific triply null mice, designated LTKO, exhibited elevated triglycerides in the liver on regular chow diet. More remarkably, LTKO mice developed severe hepatic steatosis following placement on a high fat diet. Further analyses revealed that hepatic NAD ؉ levels and Sirt1 activity were The O family members of Forkhead transcription factors (FoxOs) 3 are critical downstream effectors of the insulin/IGF-1 signaling pathway and play important roles in cellular growth and differentiation, protection against oxidative stress, and metabolic regulation (1-4). As a prototypical member of the FoxO family that includes four mammalian genes (FoxO1/3/ 4/6; FoxO2 is a pseudogene of FoxO3, and FoxO5 is the fish ortholog of FoxO3), FoxO1 has been implicated in nutrient and energy homeostasis (1-5). Although its function in glucose metabolism has been well documented (6 -12), the role of FoxO1 in hepatic lipid metabolism remains an area of active investigation (6,10,(12)(13)(14)(15)(16)(17). Adenovirus-mediated overexpression of the constitutively nuclear FoxO1 mutant (FoxO1ADA) increases triglycerides in the mouse liver but decreases triglycerides in the circulation (15). In line with this observation, deletion of FoxO1 in the liver of systemic insulin receptor (IR) knock-out mice reverses the development of hepatic steatosis (10). However, liver-specific FoxO1 knock-out mice manifest increased secretion of VLDL triglycerides in the streptozotocin-induced diabetic state (17). Moreover, the results from two transgenic lines harboring constitutively active FoxO1 alleles are contradictory in regard to its role in hepatic lipid metabolism (6,13,14). One line engineered with an S253A mutation (mouse FoxO1) leads to elevated serum and liver triglycerides (8, 13), whereas a triple substitution FOXO1TSS-A allele (T24A, S256A, and S319A in human FOXO1) exhibits lower levels of plasma triglycerides and normal levels of liver triglycerides (6). The latter finding is consistent with the observations from liver-specific IR or IR substrate (Irs1/2) knock-out mice, which have constitutively active FoxOs and lower levels of serum triglycerides due to deficiency of hepatic insulin signaling in these mice (12,18). In addition, liver-specific deletion of Akt2, the major inhibitory kinase for FoxOs, in the leptin-deficient ob/ob mice reduces fasted serum triglycerides and protects them from developing hepatic steatosis (19).In addition to phosphorylation by numerous kinases, such as Akt2, FoxOs are also subject to acetylation by several protein acetylases (20 -25). It is well known that FoxO acetylation can be reversed by NAD ϩ -dependent deacetylases (sirtuins, such as Sirt1 and Sirt2) (20 -25). Several sirtuins, including Sirt...