MIF is a multifunctional factor present at a higher concentration in sera of obese persons and in individuals with type-2 diabetes, insulin resistance, and hepatic comorbidities.23 MIF expression was found to be increased in liver biopsies of patients with NAFLD with fibrosis compared to those with no or only mild fibrosis.24,25 Studies with MIF knock-out mice in models of chronic metabolic injury imply that MIF can exert both hepatoprotective as well as pro-fibrotic effects,25,26 indicating that the role of MIF in metabolic liver diseases may be complex and context-dependent. This evidence concerns the gene MIF and Insulin resistance.