A2M and Obesity: Identifying effective lifestyle interventions and reliable noninvasive biomarkers remains a public health priority.<h4>Objective</h4>This study aimed to evaluate the effect of dietary modification on metabolic and hepatic parameters in women with MAFLD and to assess the potential role of interleukin-18 (IL-18) and alpha-2-macroglobulin (A2M) as noninvasive biomarkers.<h4>Methods</h4>A prospective interventional study was conducted on 54 women with obesity and at least one criterion of metabolic syndrome.