Additionally, miR-455-3p decreased the increased levels of TG, cholesterol, ALT and AST (Fig. 9b–d) and the high expression of TCONS_00039830, miR-455-3p and Smad2 (Fig. 9e–g) in the MASLD and MASLD + OSA-Exo groups. The gene discussed is SMAD2; the disease is obstructive sleep apnea syndrome.