INS and hyperinsulinism: When the liver accumulates fat, its gluconeogenesis strengthens, resulting in increased blood sugar, hyperglycemia can stimulate increased insulin secretion, causing hyperinsulinemia, which further promotes liver synthesis of TG aggravates the lipid deposition of the liver and forms a vicious circle.[51] Hyper TG causes increased release of free fatty acids, which interferes with the binding of insulin to receptors in the surrounding tissues, resulting in insulin resistance.[52]