In this study occurred a generation of typical hepatic alterations of NASH, as liver steatosis, hepatocellular ballooning, severe portal inflammation (a major characteristic of pediatric NASH), perisinusoidal fibrosis, besides weight gain, augmented liver weight and higher levels of proinflammatory cytokines (TNF-α and IL-6), thereby producing the key features of pediatric NASH [71]. Here, TNF is linked to metabolic dysfunction-associated steatohepatitis.