In conclusion, we demonstrated that circulating levels of SEMA3A, SEMA3C, SEMA4D, SEMA5A and SEMA7A are altered in the serum of patients with NAFLD, and SEMA3A, -3C and -4D concentrations correlated with the stage of fibrosis. This evidence concerns the gene SEMA5A and metabolic dysfunction-associated steatotic liver disease.