Fibroblast growth factor-21 (FGF-21), an endocrine hormone mainly produced by hepatocytes, contributes to glucose uptake and adiponectin production in adipocytes.390 In obesity, the expression of FGF-21 increases with the progression of MASH, whereas its effect on adipose tissue becomes resistant, as evidenced by decreased levels of adiponectin.391 As mentioned above, a decrease in adiponectin exacerbates the development of MASLD and ALD by promoting liver steatosis and insulin resistance. This evidence concerns the gene FGF21 and Insulin resistance.