Their expression is influenced by systemic inflammatory stimuli commonly present in MASLD patients [14,15], and modulation of the activin–follistatin axis has been shown to affect TGF-β1 signaling, a well-known inducer of PAI-1 expression and a key driver of hepatic fibrogenesis [16]. This evidence concerns the gene TGFB1 and metabolic dysfunction-associated steatotic liver disease.