In this scenario, evidence that bone morphogenetic protein 4 (BMP4) not only has therapeutic potential in improving whole-body insulin sensitivity and hepatic steatosis, but also has senomorphic anti-senescence effects in human hepatocytes, points to BMP4 and its antagonist gremlin 1 as novel targets to slow hepatocyte senescence, reduce IR, and prevent NAFLD progression (13, 78, 79). Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.