The expression of IL-6, the main proinflammatory cytokine, was markedly increased in the livers of patients with NASH compared to patients with simple steatosis or normal biopsies, confirming that hepatic IL-6 expression plays an important role in NAFLD progression, as well as in systemic insulin resistance, correlating plasma IL-6 levels with the degree of systemic insulin resistance [75]. This evidence concerns the gene IL6 and metabolic dysfunction-associated steatohepatitis.