AKR1B1 and metabolic dysfunction-associated steatotic liver disease: Furthermore, in patients with metabolic-associated steatohepatitis (MASH) or metabolic-associated fatty liver disease (MASLD), as well as in patients with HCC and HCC combined with diabetes, the upregulation of aldose-keto reductase family 1 member B (AKR1B1) activates the polyol pathway, enhances the Warburg effect and lipid accumulation, and promotes the occurrence of MASLD-related liver cancer and hyperglycemia-mediated HCC progression (96).