Serum IGFBP-3 is decreased in patients with NAFLD [22], whereas the IGF-1/IGFBP-3 ratio has been associated with a lower likelihood of NAFLD, lower-grade steatosis [23], and histopathologic features of the liver biopsy, including ballooning and inflammation [24]. Here, IGFBP3 is linked to metabolic dysfunction-associated steatotic liver disease.