-Disrupted Steroidogenesis: In energy metabolism defects, diminished ATP or substrate availability impairs sex steroid production.-Altered Lipid Handling: Changes in estrogen/testosterone levels can modify lipoprotein lipase (LPL) activity, influencing dyslipidemia risk.-Insulin Resistance: Elevated androgens (or abnormal estrogen) can alter adiponectin and promote insulin resistance, compounding metabolic risk in FAO disorders and certain organic acidemias. Here, LPL is linked to Insulin resistance.