INS and metabolic dysfunction-associated steatotic liver disease: Similarly, nocturnal hypoxemia metrics (AHI, desaturation burden, time with SpO2 < 90%) independently tracked with NAFLD severity after adjustment for BMI and insulin resistance, with hypoxia duration showing the strongest correlation—findings that, from an epidemiologic standpoint, identify OSA-related hypoxemia as a key exposure dimension relevant to NAFLD patients [18].