In a retrospective analysis by Ballestri et al. [16], it was noted that NAFLD itself, especially in its more severe forms, exacerbates systemic/hepatic insulin resistance, causing atherogenic dyslipidemia, and releases a variety of pro-inflammatory, pro-coagulant, and pro-fibrogenic medications that may play important roles in the pathophysiology of cardiac and arrhythmic complications. This evidence concerns the gene INS and metabolic syndrome.