Multiple mediators, including oncofetal fibronectin, insulin-like growth factor-1 (IGF-1), the receptor activator of the nuclear factor kappa B ligand/osteoprotegerin (RANKL/OPG) pathway, and several inflammatory cytokines (e.g. tumor necrosis factor [TNF]-α, interleukin-6 [IL-6], and IL-17), are commonly involved in the process of bone loss by affecting the above cells and inducing an imbalance between bone formation and bone resorption in patients with liver disease [7–9]. The gene discussed is TNF; the disease is liver disorder.