High lipid levels can also affect autophagy activity.7 Hyperinsulinemia may contribute to downregulation of autophagy through the Akt/protein kinase B (PKB) pathway in fatty liver.8 In addition, autophagy is suppressed in steatotic livers by mammalian target of rapamycin (mTOR) overactivation as a result of an increased amino-acid concentration following overnutrition.9 Therefore, a harmful cycle may exist in which independent factors promote both reduced autophagy and hepatic steatosis, and that the decrease in autophagy exacerbates steatosis, further impairing autophagy. Here, MTOR is linked to hyperinsulinism.