LEP and metabolic dysfunction-associated steatohepatitis: TNF‐α affects hepatocytes fat and suppresses adiponectin, while increasing leptin secretion.39 TNF‐α, as a pro‐inflammatory agent, increases in response to oxidative stress and contributes to inflammation in the liver via NADPH oxidase induction.43 Leptin levels considerably increase in patients with NASH.44 Increased leptin levels in NASH lead to disrupting the TNF‐α levels.