ATF4 and metabolic dysfunction-associated steatotic liver disease: However, some could be inferred by following the mechanisms elicited from PFAS hepatoxicity, such as the association of biomarkers (ALT, ALP, AST, and GGT), receptors (PPARα, CAR, and PXR), inflammatory markers (TNF-α and IL-6), unfolded protein response signaling pathway markers (IRE1α, ATF4, and BIP), fatty acid metabolic gene markers (SCD1, FASN, ACC, and SREBP1), fibrosis signaling gene markers (TIMP2, p21, and TGFβ), and gene expressions associated with NAFLD.