The activation of S1PR2 by fingolimod may also contribute to improved insulin sensitivity63 and reduced hepatic inflammation.64 As far as sphingolipid metabolism is concerned, there have been no clinical studies yet, but fingolimod and SK2 inhibitor K145276 have ameliorated NAFLD in mouse models.65S1PR2, which showed strong genetic signals in this study, is highly expressed in vascular tissue and smooth muscle, including liver, heart, kidney, lung, and brain.66 Interestingly, S1PR2 was the only gene with a strong association in liver tissue in our GPGE analyses. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.