These results confirm previous observations that a high-energy, high-carbohydrate and high-fat diet leads to a significant increase in the secretion of HSPs, which can trigger insulin resistance via inhibition of Akt phosphorylation and insulin-mediated GLUT translocation on the cell membrane and ectopic intracellular fat accumulation with NAFLD development (Angelini et al. 2018). Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.