TNF and metabolic dysfunction-associated steatotic liver disease: Furthermore, in line with the findings for TNF α plasma levels reported before by Engstler et al. for this study population, serum IL-6 protein concentrations were by trend higher in children with early signs of NAFLD than in children without any metabolic abnormalities (~+1.6-fold, p = 0.05) (see Fig 2, Table 1) [27].