The RISC study also documented the relationship between fatty liver and the presence of early plaques at carotid bifurcation, as well as the associations between carotid plaque presence and established atherosclerotic risk factors, family history of cardiovascular disease (FH-CVD) or diabetes, insulin sensitivity, serum liver enzymes, adipokines, free fatty acids and high-sensitivity C-reactive protein (hsCRP) [44,80]. Here, INS is linked to fatty liver disease.