At admission, MASLD patients had significantly higher serum levels of SEMA7A (median 31 vs. 28 ng/mL; Δ = +4.6 ng/mL, 95% CI 0.14–9.0, p = 0.043) and SEMA3A (16 vs. 15 ng/mL; Δ = +1.55 ng/mL, 95% CI 0.06–3.04, p = 0.041), and significantly lower levels of SEMA5A (15 vs. 24 ng/mL; Δ = −15 ng/mL, 95% CI −26 to −3.2, p = 0.012) compared to non-MASLD patients. The gene discussed is SEMA3A; the disease is metabolic dysfunction-associated steatotic liver disease.