In addition to FGF-19, there are other pathways such as pregnane X receptor (PXR) or G-protein-coupled bile acid receptor-1 (TGR5) that play a role in BA metabolism and are associated with the development and progression of MASLD by influencing regulatory mechanisms of IR and intestinal microbiome homeostasis [52,53]. This evidence concerns the gene GPBAR1 and metabolic dysfunction-associated steatotic liver disease.