TNF and obesity due to melanocortin 4 receptor deficiency: In the penultimate position of the paper citation ranking, Jarrar et al. [34] identified elevated TNF-α and IL-8 in NAFLD patients versus controls, with strong inter-cytokine, and linked reduced adiponectin to insulin resistance; while visfatin was elevated in obesity, it declined in NASH, and TNF-α emerged as the sole independent predictor of fibrosis, with age, ALT, IL-8, and adiponectin distinguishing NASH from simple steatosis.