Our earlier work found that, the first phase or early phase of insulin secretion were impaired in non-alcoholic fatty liver disease (NAFLD) patients when their hepatic fat content detected by 1H MRS or CT were more than 10%, which indicated that liver cell with excessive fat deposition may release some cytokines to affect the beta cell function [12,13]. The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.