Since SFRP5 has been reported to be an anti-inflammatory adipokine produced by adipose tissue [17,18,36,63], we hypothesize that the upregulation of SFRP5 mRNA abundance as NAFLD progresses may be due to an attempt to protect adipose tissue against inflammation and lipid accumulation and to counteract the inflammatory imbalance. This evidence concerns the gene SFRP5 and metabolic dysfunction-associated steatotic liver disease.