Across studies, MVs modulated oxidative stress (NOX4/ROS), inflammation (e.g., TNF-α, CXCL7), fibrotic signaling (p38 MAPK/CD36), and cell injury; cargo (e.g., miR-451a) linked to cell-cycle regulators (p15/p19) in early DN. This evidence concerns the gene NOX4 and liver dysplastic nodule.