Patients with definite/uncertain NASH had higher (not significant) insulin levels (median 31.4 mU/l; range 8.9–47.3 mU/l; normal range 2.6–24.9 mU/l) than group 4 patients without NASH (median 19.8 mU/l; range 4.8–40.0 mU/l; p = 0.065). Here, INS is linked to metabolic dysfunction-associated steatohepatitis.