The occurrence of elevated ferritin levels was higher in HBsAg-positive women, whereas elevated ferritin levels can impact the production and release of insulin, as well as enhance insulin resistance mediated by the liver.20 Thirdly, the liver, which has a crucial function in maintaining glucose homeostasis, can be adversely affected by HBV, resulting in glycometabolic dysfunction.25 This evidence concerns the gene INS and Insulin resistance.