BCKDHB and Insulin resistance: BCKDHB (branched-chain alpha-keto dehydrogenase complex) catalyzes the overall conversion of alpha-keto acids to acyl-CoA and CO2, is involved in the catabolism of the branched-chain amino acids (BCAA)33, and strongly associates with insulin resistance, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and hepatocellular carcinoma17,34.