TNF and metabolic dysfunction-associated steatotic liver disease: NAFLD association with atherosclerosis may be related to the hepatic pro-inflammatory process that stimulates reactive oxygen species to induce cytokine production (such as tumor necrosis factor-alpha (TNF-a) and interleukin-6 (IL-6)) that, together with increased hepatic C-reactive protein levels, add more atherogenic stimuli to the body [38].