Furthermore, the higher SELENOP levels in NAFLD in some studies may imply a protective mechanism that counteracts the higher oxidative stress in the initial stage of diseases, but the mechanism may be insufficient in the advanced stages, such as definite non-alcoholic steatohepatitis [24], cirrhosis [105], and hepatocellular carcinoma [106], in which lower SELENOP levels have been reported. This evidence concerns the gene SELENOP and metabolic dysfunction-associated steatotic liver disease.