But some lesions might be irreversible in NASH patients, of which the drug efficacy could marginally be improved, whereas it did not receive the attention that deserved.[27–30,32] Currently, employments of insulin sensitizers or antioxidant vitamin E for certain duration were highly debated.[37,38] A bundle of studies reported the beneficial outcomes in silymarin-treated NAFLD patients. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.