Development of obesity-associated insulin resistance and diabetes mellitus type 2 has been linked to activation of proinflammatory pathways in the liver, leading to impaired insulin signal transduction. To further define the role of hepatic NF-B activation in this process, we have analyzed glucose metabolism in mice with liver-specific inactivation of the NF-B essential modulator gene (NEMO L-KO mice) exposed to a high-fat diet (HFD). These animals are protected from the development of obesity-associated insulin resistance, highlighting the importance of hepatic NF-B activation in this context. However, hepatic NEMO deficiency synergizes with HFD in the development of liver steatosis as a consequence of decreased peroxisome proliferator-activated receptor (PPAR-␣) and increased PPAR-␥ expression. Steatosis interacts with increased inflammation, causing elevated apoptosis in the livers of these mice under HFD. These changes result in liver tumorigenesis of NEMO L-KO mice under normal diet, a process that is largely aggravated when these mice are exposed to HFD. These data directly demonstrate the interaction of hepatic inflammation, dietary composition, and metabolism in the development of liver tumorigenesis.insulin sensitivity ͉ spontaneous hepatic carcinoma ͉ steatosis ͉ hepatic NEMO deficiency E xcessive weight gain is associated with a chronic inflammatory state in white adipose tissue that releases proinflammatory cytokines such as TNF and IL-6 into circulation (1). While adipocytes have also been demonstrated to exhibit increased expression of proinflammatory cytokines in obesity (1), more recent studies have revealed that increased macrophage infiltration of white adipose tissue contributes to the proinflammatory state under conditions of obesity (2). These cytokines inhibit insulin action in classical insulin target tissues such as skeletal muscle, liver, and adipose cells, thereby resulting in alterations of glucose homeostasis (3). More recently, TNFstimulated activation of the JNK and NF-B signaling pathways has been demonstrated to inhibit insulin action in a tissuespecific manner (3-5). With respect to NF-B signaling, TNF binding induces activation of the IKK-1 and -2 kinases that are released from a multiproteincomplex containing the regulatory subunit NF-B essential modulator (NEMO), thereby mediating phosphorylation and subsequent proteasomal degradation of I-Bs liberating the transcription factor NF-B.In addition to predisposing to insulin resistance and diabetes, obesity also represents a major risk factor for the development of the malignant neoplasias (4-8). It has been clearly demonstrated that metabolic syndrome is a key factor leading to sequential development of hepatic steatosis, steatohepatitis, hepatic fibrosis, cirrhosis, and finally increased frequency of hepatocellular carcinoma (HCC) (10). Thus, steatohepatitis represents a key feature of this particular tumor entity. Recent work has also demonstrated that the NF-B signaling pathway plays a crucial role in the development of malign...