INS and metabolic dysfunction-associated steatohepatitis: Among the downregulated genes were IGF1, a hormone-like insulin that is inversely associated with liver fibrosis in diabetes patients (21), PCK1, an activator of the PI3K pathway, whose downregulation causes aggravated fibrosis and inflammation in a NASH model (22), and SOCS2, a negative regulator of cytokine signaling that suppresses inflammation during NASH progression (23).