INS and metabolic dysfunction-associated steatohepatitis: The development of steatosis in ASH/NASH is secondary to the metabolic disturbances in ASH and NASH, including insulin resistance, adipose tissue lipolysis, stimulation of de novo lipid synthesis and impaired mitochondrial fatty acid oxidation (Garcia-Ruiz and Fernandez-Checa, 2006; Garcia-Ruiz et al., 2011, 2013a,b).