HIF1A and Insulin resistance: Metabolic dysregulation-including insulin resistance, lipid accumulation, and oxidative stress-exacerbates hepatocyte injury, disrupts the balance between apoptosis and compensatory proliferation, and promotes immune evasion through pathways such as β-catenin/TNFRSF19 signaling and hypoxia-inducible factor 1-alpha (HIF-1α).