INS and obesity due to melanocortin 4 receptor deficiency: It was also revealed that BMI which related to obese is the most useful predictive factor for the onset of NAFLD which means a poorer prognosis ultimately.[46] In addition, obesity has reduced insulin sensitivity and higher susceptibility to NAFLD, which is also the main reason for the multiple body fatness of NAFLD patients.[47] However, according to our analysis data, metformin was not significantly improve BMI in patients with NAFLD (MD = −0.65, P = .12).