Thus, factors such as inflammation of AT, reversal of serum insulin and ghrelin levels, increase in hepatic lipid accumulation, infiltration of macrophages and lymphocytes, and reduction in hepatic mitochondrial content and function, with a concomitant increase in hepatic DNA damage, cell death, and compensatory proliferation, are important in the progression of HCC [185]. This evidence concerns the gene GHRL and hepatocellular carcinoma.