TNF and metabolic dysfunction-associated steatotic liver disease: H. pylori infection has also been shown to exert systemic effects through the release of vasoactive substances and inflammatory cytokines (e.g., by increasing levels of interleukin-6, tumor necrosis factor-alpha and other proinflammatory cytokines), which may play an important role in the development of NAFLD by enhancing oxidative stress, promoting the transition to adipogenesis and increasing the chance of insulin resistance 6, 29-34.