Possible mechanisms to explain the association between vitamin D level and NAFLD include vitamin D-mediated improvement in insulin secretion and insulin resistance, decreased adipose tissue inflammation, and decreased hepatic inflammation and fibrosis via the regulation of the vitamin D receptor and several cytokines, such as interleukin 6, TNF-α or adiponectin [19, 35, 36]. This evidence concerns the gene TNF and metabolic dysfunction-associated steatotic liver disease.