Age > 65 years, heavy drinking, presence of fatty liver, insulin therapy, low triglyceride (TG) level, high alkaline phosphatase, high aspartate aminotransferase, high gamma-glutamyl transferase (GGT), low platelet counts, high FIB-4 scores and high APRI values were associated with HCC development in derivation cohort. This evidence concerns the gene INS and hepatocellular carcinoma.