In addition to this, there is growing evidence that NAFLD causes alterations in the production of several molecular coordinators that may be detrimental to bone health, such as overproduction of TNF-a (32) and deficiencies in vitamin D (33), osteopontin (34) and osteoprotegerin (35). The gene discussed is TNFRSF11B; the disease is metabolic dysfunction-associated steatotic liver disease.