In fact, our aim was not to study NASH; instead we focused on the most sensitive non-invasive parameter (liver fat content measured with 1H MRS) which has been shown to be highly correlated with whole body insulin sensitivity19 and metabolic imbalance can be detected at an early stage (liver fat content varying between 0.5% and 39.3%)20. Here, INS is linked to metabolic dysfunction-associated steatohepatitis.