Bechmann et al. observed that KLF6 IVS1-27G wild-type allele was associated with stepwise increase in fasting plasma glucose and insulin and reduced hepatic insulin sensitivity [245], and the effect was at least partially mediated by reduced expression of glucokinase, raising the possibility that the effect of this variant on the progression of liver damage in NASH might entail regulation of glucose and lipid metabolism. This evidence concerns the gene INS and metabolic dysfunction-associated steatohepatitis.