Liver X receptor (LXR) agonists exert potent antiatherosclerotic actions but simultaneously induce excessive triglyceride (TG) accumulation in the liver. To obtain a detailed insight into the underlying mechanism of hepatic TG accumulation, we used a novel computational modeling approach called analysis of dynamic adaptations in parameter trajectories (ADAPT). We revealed that both input and output fluxes to hepatic TG content are considerably induced on LXR activation and that in the early phase of LXR agonism, hepatic steatosis results from only a minor imbalance between the two. It is generally believed that LXR-induced hepatic steatosis results from increased de novo lipogenesis (DNL). In contrast, ADAPT predicted that the hepatic influx of free fatty acids is the major contributor to hepatic TG accumulation in the early phase of LXR activation. Qualitative validation of this prediction showed a 5-fold increase in the contribution of plasma palmitate to hepatic monounsaturated fatty acids on acute LXR activation, whereas DNL was not yet significantly increased. This study illustrates that complex effects of pharmacological intervention can be translated into distinct patterns of metabolic regulation through state-ofthe-art mathematical modeling.-Hijmans, B. S., Tiemann, C. A., Grefhorst, A., Boesjes, M., van Dijk, T. H., Tietge, U. J. F., Kuipers, F., van Riel, N. A. W., Groen, A. K., Oosterveer, M. H. A systems biology approach reveals the physiological origin of hepatic steatosis induced by liver X receptor activation. FASEB J. 29, 1153-1164 (2015). www.fasebj.org Key Words: computational modeling • T0901317 • fatty liver • FFA flux • VLDL metabolism LIVER X RECEPTORS (LXRS) are transcription factors that play a central role in the regulation of lipid and carbohydrate metabolism (1). Under physiologic conditions, LXRs are activated by oxygenated metabolites of cholesterol (2). Because LXR agonism raises plasma HDL levels (3, 4), potently promotes cholesterol excretion (5, 6), and reduces atherosclerotic plaque formation in rodent models (7), LXR is considered an attractive drug target for antiatherosclerotic therapies (8, 9). LXR agonists, however, also cause severe hepatic triglyceride (TG) accumulation in animal models (3,4). This has been attributed to transcriptional up-regulation of lipogenic genes (10, 11) and subsequent stimulation of de novo lipogenesis (DNL) in the liver. The induction of hepatic steatosis is a major drawback for the clinical application of LXR agonists because this condition may predispose to the development of nonalcoholic steatohepatitis and eventually hepatocarcinoma (12).Increases in hepatic TG synthesis and content on pharmacological LXR activation are generally believed to be driving forces for the secretion of large, TG-rich very lowdensity lipoprotein (VLDL) particles by the liver (4). Published data on the effects of pharmacologic LXR agonism on plasma VLDL-TG levels indicate transient effects in rodents and nonhuman primates (4,11,(13)(14)(15). The mechanistic b...