PRRT2 and metabolic dysfunction-associated steatotic liver disease: Besides this, previous reports have shown that increased intramyocellular droplet storage results in the accumulation and dysregulation of detrimental lipid intermediates, such as diacylglycerols and ceramides, which leads to insulin resistance by the activation of PKC and contributes to the development of muscle loss in obese human subjects (23, 24), suggesting that lipid dysfunction in muscle also affects insulin resistance and muscle atrophy in patients with NAFLD and NASH [8].