Both, the dramatic down-regulation of hepatic Igf1 expression and the upregulation of Igfbp1, which were reflected in changes of the serum levels of these proteins, were observed in several clinical studies and are strongly associated with NAFLD and the metabolic syndrome (Völzke et al., 2009; Alderete et al., 2011; Mallea-Gil et al., 2012). The gene discussed is IGF1; the disease is metabolic dysfunction-associated steatotic liver disease.