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. 2019 Jul 3;12:1001–1012. doi: 10.2147/DMSO.S212715

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© 2019 Gharaibeh et al.

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Lipid synthesis and deposition in hepatocytes in normal individuals. Blood glucose level is determined by food intake and endogenous glucose production from hepatic gluconeogenesis and glycogenolysis. Systemic and hepatic insulin resistance is normal. Increased glucose levels stimulate insulin secretion and increase blood insulin levels. Glucose and insulin each stimulate a cascade of metabolic events in liver to increase de novo fatty acid and cholesterol synthesis. In addition, hepatic lipid content is directly related to quantity and composition of food, and uptake of circulating non-esterified fatty acids released from adipose tissue. On the other hand, hepatic beta-oxidation (and ketogenesis) that can be activated by glucagon, and export of very low-density lipoprotein (VLDL) are the main mechanisms through which liver fat content is decreased. Blood glucagon/insulin ratio is normal.