In addition, higher TSH levels can induce steatosis via TSH receptor (TSHR) signaling, by also increasing hepatic gluconeogenesis, repressing hepatic bile acid synthesis, and causing hypercholesterolemia by decreasing 3-hydroxy- 3-methylglutaryl-CoA reductase phosphorylation. The gene discussed is HMGCR; the disease is familial hypercholesterolemia.