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Notably, lipid overload also triggers endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) : on one hand, the UPR exacerbates insulin resistance via the PKR-like Endoplasmic Reticulum Kinase (PERK)-eukaryotic Initiation Factor 2 alpha (eIF2)-Activating Transcription Factor 4 (ATF4) axis

Additionally, surgery often involves anesthesia drugs that can directly or indirectly affect mitochondria e.g

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As the disease progresses, diminishing levels of FABP1 potentially leads to increased levels of lipids, with ensuing lipotoxicity promoting disease progression by damaging essential organelles and cells in the liver (Fig