INS and steatosis: In obese, hyperinsulinemic, insulin resistant states such as the aged SHR rat, increased hepatic fatty acid level resulting from increased adipose lipolysis and subsequent plasma FFA uptake, dietary fat intake and/or de novo lipogenesis can potentiate increased inappropriate hepatic fat accumulation (e.g., steatosis) and fatty acid oxidation with ensuing cellular pathological consequences, termed lipotoxicity [49, 56, 65, 74–77], reviewed in [78, 79].