INS and metabolic dysfunction-associated steatohepatitis: In contrast, insulin sensitizers, such as pioglitazone (Promrat et al., 2004; Sanyal et al., 2004; Aithal et al., 2008), rosiglitazone (Ratziu et al., 2008), and metformin (de Oliveira et al., 2008), can attenuate NASH-related hepatic fibrosis.