Moreover, metabolic and immune pathways are also heavily implicated in the sexual dimorphism of NAFLD, as males are indicated to associate more strongly than females with pathways related to phospholipid, lysophospholipid, phosphatidylinositol metabolism, and insulin signaling, and females and males demonstrated differential tissue specificity for various immune pathways. This evidence concerns the gene INS and metabolic dysfunction-associated steatotic liver disease.