INS and metabolic dysfunction-associated steatotic liver disease: For instance, Michail et al. (2015) pointed that children with NAFLD had a significantly higher level of ethanol compared with the controls, which were associated with a greater abundance of Gammaproteobacteria and Prevotella. However, Engstler et al. (2016) demonstrated in mice models and patients that the increased blood ethanol levels in NAFLD might result from insulin-dependent impairments of ethanol dehydrogenase activity in the liver rather than an increase in endogenous ethanol synthesis.