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Brito A, Verdugo R, Hertrampf E, Miller JW, Green R, Fedosov SN, Shahab-Ferdows S, Sanchez H, Albala C, Castillo JL, et al

The first one involves irreversible damage to the ETC, possibly through TTC5 upregulation, resulting in ATP loss, increased mitochondrial superoxide production and caspases 3/7 activation, and subsequent apoptosis

Since the liver is the major site of IGF-1 production, when steatosis develops lowering insulin sensitivity, the severity of steatosis at different stages of insulin resistance and metabolic syndrome seems to be correlated with worsened circulating IGF-1 levels [234]