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E-selectin is induced by inflammatory cytokines, whereas ICAM-1 and VCAM-1 are expressed by endothelial cells in response to inflammatory cytokines, elevated levels of FFA and oxidized low-density lipoprotein cholesterol.24,25 There is a clear association between hepatic lipid deposition and several features of insulin resistance (hyperinsulinemia, hypertriglyceridemia and low HDL concentration) and less hepatic insulin sensitivity is associated with more liver adipose tissue content.26 The molecular mechanisms associated with the development of hepatic insulin resistance have been studied and include a decrease in insulin-stimulated tyrosine phosphorylation of IRS-1 and IRS-2, which blocks the ability of insulin to activate glycogen synthase, diminishes the ability to store glycogen and increases gluconeogenesis.27 The increases in intracellular triglyceride content in tissues of humans with insulin resistance and metabolic syndrome can be related to increases in the uptake of FFA from plasma, an enhanced rate of de novo fatty acid synthesis, and a dysregulation of intracellular lipid partitioning in which fatty acid oxidation is impaired and its esterification enhanced

Plus, alcohol can lower blood sugar levels, which might contribute to feelings of weakness and fatigue

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