Moreover, lower SPISE index significantly correlated in adults or adolescents with the presence of T2D [36], metabolic syndrome [37, 39], risk of cardiovascular diseases [36], non-alcoholic fatty liver disease (NAFLD)[38], abdominal obesity, higher levels of C-reactive protein (CRP) and lower levels of adiponectin[24]. This evidence concerns the gene CRP and metabolic dysfunction-associated steatotic liver disease.