Dysfunctional visceral adipose tissue also contributes to the production and secretion of TNF-α, mainly produced by immune cells infiltrating the adipose tissue, when it is expanded (e.g., in obesity); TNF-α of extra-hepatic origin is delivered to the liver via systemic circulation, along with other cytokines and adipokines, which may also affect the development and progression of NAFLD [7]. This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.