However, over time, endotoxemia contributed by differences in gut microbial dysbiosis among lean-MAFLD but not healthy individuals or overweight/obese-MAFLD patients results in alterations in the epigenomic and transcriptome including upregulation of Toll-Like Receptor 4 (TLR4). The gene discussed is TLR4; the disease is serum lipopolysaccharide activity.