AHSG and Insulin resistance: Possible mechanisms for the lowering of fetuin A levels by exercise include: decreases in intrahepatic fat content by reduction of sterol regulatory element-binding protein (SREBP)-1cand enhanced peroxisome proliferator-activated receptor γ (PPAR-γ) expression; decreased hepatic glucolipotoxicity by reactive oxygen species (ROS); inhibition of pro-inflammatory mediators; and activation of Akt and Akt substrate of 160 kDa (AS160) phosphorylation, which in turn reduce insulin resistance (51).