Abstract. Obesity is less common in the Asian population, but Asian people may be susceptible to obesity-associated metabolic dysregulation. Accumulating evidence suggests that insulin resistance is closely associated with ectopic fat accumulation in the liver. Whether this correlation is due to a causal relationship between the conditions has long been the subject of debate. Insulin resistance and type 2 diabetes affects liver pathology, typically leading to nonalcoholic fatty liver disease (NAFLD) by dynamically altering the hepatic genes involved in glucose and lipid metabolism. Conversely, how overnutrition induces hepatic insulin resistance has been studied intensively, and has been shown to involve excessive energy flux into mitochondria, toxic lipids, reactive oxygen species, and hepatokines. In this review, we focus on NAFLD both as a consequence and as a cause of insulin resistance through lessons learned from the liver of patients with type 2 diabetes.Key words: Fatty liver, Mitochondria, Reactive oxygen species, Hepatokine, Selenoprotein P TYPE 2 DIABETES is a multifactorial disease that involves a genetic predisposition and/or environmental factors leading to absolute and relative deficiencies in the actions of insulin. Recent studies have unraveled the humoral and nutritional factors, and a neuronal pathway that may govern inter-organ networks [1]. The disruption of inter-organ networks leads to insulin resistance, an underlying feature involved in the pathogenesis of type 2 diabetes and its related vascular complications. Specifically, the liver functions as a control tower to maintain human body energy homeostasis by sensing nutrient stimuli via portal vein and by producing a variety of nutrients and bioactive substances. Indeed, disruption of hepatic insulin signaling in liver-specific insulin receptor knockout (LIRKO) mice results in fasting and postprandial hyperglycemia and the subsequent development of peripheral (muscle) insulin resistance [2], whereas glucose homeostasis remains normal in mice of disrupted insulin signaling both in the skeletal muscle and adipose tissue [3]. These observations suggest that hepatic insulin resistance is the primary event leading to diabetes and the subsequent development of peripheral tissue insulin resistance.Over-nutrition is one of the major environmental factors that disrupt the inter-organ networks [1]. However, obesity is less common in Asian population. Nevertheless, Asian people may be suceptible to obesity-associated metabolic dysregulation. Accumulating evidence suggests that diabetes, obesity, and insulin resistance are closely associated with ectopic fat accumulation especially in the liver. Hepatic steatosis is often accompanied by hepatic insulin resistance. Whether this correlation is due to a causal relationship between the conditions has been the subject of considerable debate [4].In this review, we focus on nonalcoholic fatty liver disease (NAFLD) both as a consequence and as a cause of insulin resistance mainly through lessons learned from...