GREM1 and metabolic dysfunction-associated steatohepatitis: Furthermore, adipose tissue dysfunction and inflammation are both important factors in the pathogenesis of MASLD and MASH fibrosis (Gastaldelli and Cusi, 2019), and Gremlin-1 has been described to drive adipogenesis and adipocyte dysfunction in hypertrophic adipose tissue (Grillo et al., 2023).