The pathogenesis of NAFLD is not a simple mechanism and the theory of the “two-hit model” is the most widespread: The first hit is insulin resistant promoting hepatic fat accumulation, and the second hit, through a large number of adipokines (leptin, adiponectin, resistin), is sustained by FFAs that induce ROS injury [114]. Here, LEP is linked to metabolic dysfunction-associated steatotic liver disease.