The lack of correlation between the expression level of SIRT1 in PBMCs and MASLD biomarkers/indexes, and the apparently inconsistent result observed in the expression level of FOXO1 in PBMCs in our study and the study of Valenti et al. [80] in liver biopsies in 27 patients with MASH, can be explained by the fact that our participants were apparently healthy postmenopausal women with overweight/obesity and were not clinically diagnosed with MASLD/MASH, and based on the index used some of them might have developed early stages of MASLD (liver steatosis). Here, SIRT1 is linked to obesity due to melanocortin 4 receptor deficiency.