In hepatocytes, tumor necrosis factor alpha (TNFα) or interleukin-1 beta (IL-1β) mediated inflammatory stress significantly reduced intracellular cholesterol efflux by inhibiting PPAR, LXR, and ABCA1 expression and increased LDLR and SREBP-2 expression and suggesting that inflammatory stress may exacerbates progression of fatty liver in NAFLD (157). This evidence concerns the gene TNF and fatty liver disease.