INS and metabolic dysfunction-associated steatohepatitis: However, taking into account fasting hyperinsulinaemia in patients with NASH, the calculated adipose IR index (fasting NEFA × fasting insulin 31) was significantly elevated (64.4 ± 9.1 vs. 20.5 ± 3.9 mmol/l pmol/l; p = 0.0002) in patients with NASH.