Several mechanisms have been proposed to explain how NASH increases HCC risk, including the prevalence of insulin resistance among obese individuals, which results in elevated circulating concentrations of insulin and insulin-like growth factor 1 (IGF-1) [7] and a low-grade inflammatory response with elevated production of cytokines, such as TNF and IL-6 [8]. The gene discussed is IGF1; the disease is metabolic dysfunction-associated steatohepatitis.