A recent study of 40 non-diabetic and mostly non-obese patients with biopsy-proven MAFLD and varying severity of hepatic steatosis and fibrosis, indicated a link between adipose tissue insulin resistance and Kupffer cell activation since sCD163 concentrations associated with circulating free fatty acids, lipolysis rate and insulin resistance in adipose tissue (74). The gene discussed is INS; the disease is fibrosis.