INS and type 2 diabetes mellitus: In a substudy of SURPASS-3 involving patients with type 2 diabetes and a liver index more than 60, tirzepatide was found to lower liver fat content considerably compared to insulin [36]; in addition, a post hoc analysis of phase 2 clinical trial by Hartman et al. showed that in the T2DM population, high doses of the dual GIP/GLP-RA agonist, tirzepatide, significantly improved K-18, Pro-C3, and lipocalin compared to placebo, while ALT and AST were dose-dependently reduced relative to baseline, but not to a greater extent than placebo [27].