Besides, chronic HFD exposure often fires “multiple hits” in the liver, resulting in impaired insulin response cascades and leading to insulin resistance, which has become an important complication and diagnostic index of NAFLD.33 In this regard, after Zbtb18 overexpression we also found a glucose intolerance improvement and a reduced insulin resistance, coupled with an enhanced phosphorylation of AKT and GSK-3β in the liver. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.