INS and metabolic dysfunction-associated steatohepatitis: In addition to its key role in regulating insulin resistance, ceramide could also inhibit FAO [23], promote triglyceride synthesis, induce hepatic lipid accumulation and lipotoxicity, induce oxidative stress, stimulate cytokine expression, induce mitochondrial dysfunction and provoke apoptosis, all of these are mechanistically involved in the pathogenesis of NASH [5, 21, 24–27].