INS and metabolic dysfunction-associated steatohepatitis: Several animal studies demonstrated the development of liver steatosis, insulin resistance, altered lipid metabolism, and progression of NASH to HCC via either SREB1 (sterol regulatory element-binding protein), PEPCK (phosphoenolpyruvate carboxykinase), and PTB-1B (protein tyrosine phosphatase 1B) or SREB2 and CYP27A1 [89].