There was a greater decrease in liver fat content.Supplementation did not lead to improvement in the primary histological activity score in patients with NASH (≥2-point reduction in NAS).No independent effects on the markers of hepatocyte damage or the indicators of insulin sensitivity were observed.There was no improvement in cell injury biomarkers (M30 and M65) that did not occur uniformly with N-3 PUFA and only occurred with concomitant weight loss.There were no consistent beneficial effects on blood lipid composition (aside from a trend in triglyceride reduction) or insulin sensitivity. Here, INS is linked to metabolic dysfunction-associated steatohepatitis.