According to a case series, 89 patients with psoriasis, metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD) who were treated with etanercept (a TNF-α inhibitor), as opposed to psoralen–ultraviolet A, showed a significant decrease in their fasting insulin, aspartate aminotransferase/alanine transaminase ratio, homeostasis model assessment index, and C-reactive protein levels [72]. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.