There were seven studies that assessed a range of metabolic co-morbidities in addition to NAFLD, including one or more of the following: type 2 diabetes mellitus, insulin resistance, higher fasting insulin levels, obesity, hypertension, hypercholesterolaemia, hypertriglyceridemia [22,24,27,33,34,38,42]. This evidence concerns the gene INS and metabolic dysfunction-associated steatotic liver disease.