Simultaneously, an altered secretome (decreased hepatoprotective adiponectin and omentin and increased pro-inflammatory adipokines such as leptin, resistin, chemerin, visfatin, and elevated chemokines (mostly monocyte chemoattractant protein 1 (MCP-1))) promotes hepatic steatosis, further impairs sensitivity to insulin, as well as induces Kupffer cell activation and fibrogenesis [49,50,51,52]. The gene discussed is INS; the disease is fatty liver disease.