Patients with NAFLD have 26% additional risk to VDD as compared to controls owing to the impairment of 25 (OH)D synthesis due to the presence of steatosis (Eliades et al., 2013), in addition vitamin D receptor (VDR) expression in the hepatocytes decreases as the extent of the disease increase (Barchetta et al., 2012). This evidence concerns the gene VDR and metabolic dysfunction-associated steatotic liver disease.