Importantly, FXR modulates BA,28 glucose and lipid homeostasis,30–33 as well as immune responses and insulin signaling.30 TGR5 plays an important role in energy homeostasis, insulin signaling, and inflammation.30 As these metabolic processes are perturbed along the NAFLD spectrum, disruptions in BA homeostasis may perturb these metabolic processes via deregulation of their receptors. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.