Altered expression and methylation patterns of nine genes encoding key enzymes involved in intermediary metabolism (e.g., pyruvate carboxylase [PC], ACLY, and phospholipase C gamma 1 [PLCG1]) and insulin signaling (e.g., insulin like growth factor 1 [IGF1], insulin like growth factor binding protein 2 [IGFBP2], and PRKCE) were associated with NAFLD. The gene discussed is IGF1; the disease is metabolic dysfunction-associated steatotic liver disease.