Additionally, a study in an animal model found that high salt intake activates the aldose reductase-fructokinase pathway in the liver and hypothalamus, leading to endogenous fructose production and the development of leptin resistance and hyperphagia, which are known to cause obesity, insulin resistance, and fatty liver58,59. The gene discussed is AKR1B1; the disease is obesity due to melanocortin 4 receptor deficiency.