High insulin levels accelerate the development of NAFLD through a PPARγ-dependent pathway.387 PPARγ agonists, thiazolidinediones, have been used as insulin sensitizers in diabetic patients.388 PPARδ agonists improved the pathological manifestations of nonalcoholic steatohepatitis (NASH) without affecting body weight. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.