INS and metabolic dysfunction-associated steatohepatitis: One of the first lines of evidence regarding this was provided by the finding that insulin sensitizers failed to invariably reverse NASH in all cases, did not reverse or even worsened mitochondrial abnormalities in NASH and, conversely, histological improvement, at least in some patients, was observed with pharmacological agents, such as vitamin E, acting through mechanisms other than insulin sensitization [49].