Figure 1

Hydrolysis of imcTG produces DAG and LCACoA which is also precursor to ceramides. All three can activate PKC isoforms that inhibit insulin signaling. An enlarged and rapidly turning over imcTG pool increases the release of these fatty acid derivatives, thus causing MIR. Simultaneously, mitochondrial β-oxidation may increase given the large fatty acid flux thereby worsening MIR. FFA, (plasma) free fatty acids; LCFA, long chain fatty acids; LCACoA, long chain acyl CoA; LCAC, long chain acylcarnitines; PL, phospholipids; DAG, diacylglycerol; PKC, protein kinase C; β, mitochondrial β-oxidation.