“…Experimental plasma FFA elevation impairs glucose oxidation/glycogen synthesis and decreases glucose transport, which leads to organ-specific insulin resistance in adipocytes, skeletal muscle cells, and hepatocytes, 5,6) whereas lowering FFA levels in vivo and vitro significantly improves insulin sensitivity. 7,8) Prolonged exposure to elevated FFA results in the production of inflammatory factors by stimulating the nuclear factor-B (NF-B) pathway, [9][10][11] and induces activation of Jun N-terminal kinase-3 (JNK3), which accelerates -oxidation of FFA, brings about excessive electron flux in the mitochondrial respiratory chain, and subsequently causes increased reactive oxidant species (ROS) generation. 5,12,13) All of this has passive effects on the insulin signal transduction pathway, leading to decreased activity of phosphatidylinositol-3 kinase (PI3K), reduced phosphorylation of the three known isoforms of Akt, and impaired translocation of glucose transporter-4 (Glut4), finally resulting in inhibited glucose uptake and utilization.…”