IGF1 and metabolic dysfunction-associated steatotic liver disease: They also showed that, in 32 weeks, IGF-1 was lower in mice fed with HFD resulting to reduced osteoblast activity, justifying bone changes in the progressive stage of NAFLD (61).In addition to the aforementioned factors, vitamin D deficiency, which has known effects on bone metabolism, seems to also influence NAFLD progression by inducing pro-inflammatory processes and oxidative stress, as well as stimulating the proliferation of stellate cells and the production of pro-fibrotic factors (e.g. PDGF and TGFβ) (14).