IGF1 and metabolic dysfunction-associated steatotic liver disease: IGF-1 is known to play a protective role in ischemic heart and cardiovascular disease and atherosclerosis [78,79,80,81] and a study by Ichikawa et al. [82] confirmed down regulation in IGF-1 in NAFLD patients due to an inhibition of IGF-1 secretion via interleukin-1β (IL-1β), interleukin-6 (IL-6) and TNF-α.