ANPEP and metabolic dysfunction-associated steatotic liver disease: HMW APN, which functions to activate the AMP‐activated protein kinase (AMPK) signaling pathway in the liver as target organ, is the predominant form of endogenous APN related to metabolic effects.18 Additionally, Bianchi et al15 concluded that APN levels were reduced in NAFLD patients, without any significant contribution of isoform distribution to progressive liver disease.