The results indicated that before ex vivo metformin treatment the monocyte TLR4 level was strongly associated with NAFLD (P≤0.023) and TNFα (P≤0.01) while after the treatment these significances were lowered to P≤0.05 and P≤0.09, respectively. This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatotic liver disease.