The altered hormone signaling pathways can lead to increased fat tissue, abnormal fat cell size, number and function, altered fat cell growth, increased insulin secretion, altered hypothalamic satiety and appetite neurons (the homeostatic pathway), NAFLD, leptin and insulin resistance, altered microbiome and inflammation: effects seen in and that support both EBM and CIM. The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.