In addition, excessive FFAs in the liver, the release of inflammatory mediators from dysfunctional adipose tissue (such as MCP-1, IL-6, and TNFα) (DI Maira et al., 2018), and endotoxins derived from gut (Carnevale et al., 2017) in diabetic patients with NAFLD also activate hepatic Kupffer cells (Kazankov et al., 2019) and release liver inflammatory mediators (IL-1β, TNFα, IL-6) to promote liver injury and inflammation (Yu et al., 2019). This evidence concerns the gene IL6 and metabolic dysfunction-associated steatotic liver disease.