Although the role of diabetes in hepatic steatosis and in its progression to NASH still remains unclear [45], the NHANES-III reported that simple IR features, such as fasting insulin, Hb A1c, and C-peptide concentrations, as well as abdominal obesity markers were independently associated with ALT concentrations, the most sensitive indicator of liver cell integrity. This evidence concerns the gene GSTM1 and metabolic dysfunction-associated steatohepatitis.