Turkish AR, Sturley SL. The genetics of neutral lipid biosynthesis: an evolutionary perspective. Am J Physiol Endocrinol Metab 297: E19 -E27, 2009. First published December 30, 2008 doi:10.1152/ajpendo.90898.2008.-The storage of fatty acids and fatty alcohols in the form of neutral lipids such as triacylglycerol (TAG), cholesteryl ester (CE), and wax ester (WE) serves to provide reservoirs for membrane formation and maintenance, lipoprotein trafficking, lipid detoxification, evaporation barriers, and fuel in times of stress or nutrient deprivation. This ancient process likely originated in actinomycetes and has persisted in eukaryotes, albeit by different molecular mechanisms. A surfeit of neutral lipids is strongly, perhaps causally, related to several human diseases such as diabetes mellitus, obesity, atherosclerosis and nonalcoholic fatty liver disease. Therefore, understanding the metabolic pathways of neutral lipid synthesis and the roles of the enzymes involved may facilitate the development of new therapeutic interventions for these syndromes. STORAGE OF FATTY ACIDS, fatty alcohols, and sterols in the form of neutral lipids serves to allocate resources for potential use in vital functions such as membrane formation, epidermal integrity, bile acid synthesis, lipoprotein trafficking, and steroidogenesis. Neutral lipids, such as cholesteryl ester (CE), triacylglycerol (TAG), and wax ester (WE), provide organisms with inert forms of energy used in conditions of nutrient deprivation and environmental stress. They also provide an excellent "sink" to buffer the toxic effects of fatty acids and fatty alcohols. In times of plenty (such as a typical Western diet), energy in the form of fat is efficiently stored, but with consequences. Elevated cytoplasmic deposition of neutral lipids (primarily CE and TAG) is a significant risk factor for several disease pathologies, including diabetes, obesity, atherosclerosis, and nonalcoholic fatty liver disease (41,53,101). For example, the accumulation of CE in smooth muscle cells and macrophages in the vessel wall comprises the earliest recognizable stage in atherosclerotic plaque formation (90). Furthermore, serum levels of TAG and total cholesterol are independent risk factors for atherosclerosis. Similarly, the loading of TAG into the cytoplasm of adipocytes represents the basic unit of obesity and thus accounts for fat accumulation in all obese syndromes.TAG, a fatty acyl ester derivative of glycerol, represents the major energy depot of all eukaryotic and some bacterial cells (16) and is formed primarily via an acyl-CoA diacylglycerol acyltransferase (DGAT) reaction, although in some organisms acyl-CoA-independent reactions also contribute to these pools. The energy of complete oxidation of the alkyl chains of TAG (38 KJ/g) is more than twice the same weight of carbohydrate or protein, and unlike polysaccharide, TAG carries no extra weight as water of solvation. Furthermore, TAG is deposited into cytoplasmic lipid droplets and thus has no effect on the osmolarity of the...