Given that hepatic steatosis produces proinflammatory cytokines such as IL-1β, IL-6, C-reactive protein, and TNF-α, which contribute to endothelial dysfunction and myocardial deformation,40 the present findings may also be secondary to the improvement in systemic insulin resistance in association with the inhibition of proinflammatory cytokine production in the liver. Here, TNF is linked to endothelial dysfunction.