Among all liver enzymes, GGT is the most sensitive liver parameter for prediction of NAFLD and its sequelae35–37 Insulin levels—being part of the badly performing NAFLD-LFS—may not necessarily reflect a metabolic improvement, especially in the context of T2DM patients with primarily reduced insulin secretion capacity, who often lack NAFLD11,38. The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.