TNF and metabolic dysfunction-associated steatotic liver disease: Thirdly, elevated serum folate levels attenuate the expression of proinflammatory cytokines (IL-6 and TNF-α), inhibiting Kupffer cell recruitment and activation, ultimately reducing the risk of MASLD (29); Fourthly, folic acid modulates liver microRNAs, contributing to lower blood glucose and lipid concentrations, improved insulin sensitivity, and enhanced liver function (30).