INS and metabolic dysfunction-associated steatotic liver disease: However, the identified observational studies included diverse outcomes, such as different types of cancer (21–23, 26), prehypertension (28), newly diagnosed nonalcoholic fatty liver disease (NAFLD) (27), insulin homeostasis (25), thickened carotid intima-media thickness (cIMT) (24), risk of depressive symptoms (20) and handgrip strength (19).