INS and metabolic dysfunction-associated steatotic liver disease: By activating the NF-κB signaling pathway, TNF-α induces hepatocyte apoptosis, promotes reactive oxygen species (ROS) production, and disrupts insulin signaling, serving as a central mediator in the inflammatory progression of NAFLD (54).Existing studies have shown that serum TNF-α levels are positively correlated with intrahepatic triglyceride levels (r = 0.28, P < 0.04) (55), suggesting potential for early screening and targeted therapy research.