ESRRA and Insulin resistance: Using a high-fat (HF) diet induced insulin resistance in C57BL/6 J mice, Tuikka et al. [41] found that long-term high fatty acid intake activated PGC-1α and female ERRα, increased PDK4 expression, inhibited the effect of pyruvate dehydrogenase, and led to insulin resistance, suggesting that PDK4 is a possible contributor to high-fat diet-induced insulin resistance.