Hepatic insulin clearance, measured as the ratio between AUCs of C-peptide and insulin during an OGTT decreased linearly with increased hepatic TG content and explained the progressive increase in basal insulin concentration and HOMA-IR in the large US cohort of 352 middle-aged obese individuals (mean BMI, 33.1 ± 5.3 kg/m2) including a 61% prevalence of type 2 diabetes [28]. Here, INS is linked to type 2 diabetes mellitus.