Collectively, these adipose tissue secretomes lead to further systemic complications associated with MS8, such as nonalcoholic steatohepatitis (NASH), which evolves and progresses owing to the activation of the hepatic Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB)/TNF-α/transforming growth factor-β1 (TGF-β1) signaling pathway by endotoxemia resulting from an excessive HFHF dietary intake4,9,10. Here, TNF is linked to serum lipopolysaccharide activity.