Both NAFLD and NASH are strongly associated with a clustering of cardio-metabolic risk factors including obesity, hypertension, atherogenic dyslipidemia, lower plasma insulin-like growth factor-1 (IGF-1) levels, higher plasma inflammatory and hemostatic factors, insulin resistance, metabolic syndrome, endothelial dysfunction, impaired glucose tolerance, and type 2 diabetes [9]–[15]. The gene discussed is IGF1; the disease is metabolic syndrome.