INS and metabolic dysfunction-associated steatotic liver disease: There were substantial researches exploring the associations of VAI with chronic diseases in human, which proved that VAI was negatively associated with insulin sensitivity [16,17] and identified as a powerful indicator for pre-diabetes or diabetes [18,19,20], and positively associated with the risk of hyperuricemia [21] and nonalcoholic fatty liver disease (NAFLD) [22].