Fat accumulation and the expression of TCONS_00039830, miR-455-3p and Smad2 were examined in the Control, MASLD, MASLD + OSA-Exo, MASLD + miR-455-3p and MASLD + miR-455-3p + OSA-Exo groups to verify the role of miR-455-3p in mediating the regulatory effects of exosome-mediated TCONS_00039830 on fat accumulation. This evidence concerns the gene SMAD2 and obstructive sleep apnea syndrome.