After 16 weeks, the high trans-fat diet without the addition of fructose led to the development of a NASH-like phenotype with associated necroinflammatory changes, obesity, insulin resistance, and high plasma ALT levels accompanied by inflammatory and profibrogenic responses (as shown by the increased liver TNF-α and procollagen mRNA levels), as well as elevated levels of plasma insulin, resistin, and leptin [104,105]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.