Among the 13 DEGs associated with the NAFLD pathway and Insulin signaling pathway (Additional files 1 and 7) (http://www.genome.jp/kegg/) studied by qPCR, ten were (highly) significantly upregulated in the HCBD group (in comparison to the control group), whereas three were (highly) significantly downregulated (Fig. 5). The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.