CPT1A and Insulin resistance: Notably, several authors demonstrated that the metabolic flexibility of mitochondria is lost along with disease progression [11,12], oxidative stress being pointed out as the main contributor of mitochondrial dysfunction characterized by decreased carnitine palmitoyl transferase-1α (CPT-1α), OXPHOS complexes activities and respiration, high proton leak rate, and development of insulin resistance in NASH [10,13].