More commonly, NAFLD is associated with increased VLDL secretion due to elevated TG availability for the intrahepatic ApoB lipidation process (23), resulting in the characteristic mixed hyperlipidemia in which both VLDL and low-density lipoprotein (LDL) are increased that is often observed in insulin resistant and diabetic patients with NAFLD. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.