Table 1.

Mechanisms linking MAFLD with peripheral Insulin Resistance.

Sub-Group	Liver-Derived Factor	Regulatory Mechanisms
Hepatokines	Activin E Fetuin A Fetuin B Visfatin Chemerin DPP4 FGF21 RBP4 SHBG	Uncoupled respiration Peripheral insulin sensitivity Insulin receptor pathway Cellular metabolism and appetite control Glucose and lipid homeostasis Insulin release from β-cells Mitochondrial biogenesis Immunity Hepatic steatosis
Liver-secreted metabolites	Ketones Uric Acid Lipoproteins Bile Acids Acylcarnitines	Lipid metabolism Peripheral insulin sensitivity Appetite control Oxidative stress and inflammation Intra-hepatic lipid synthesis Fuel source for thermogenesis
Liver-derived mi-RNAs	miR-802 miR-144 miR-122 miR-33 miR-34a miR-21	Peripheral insulin sensitivity Hepatic lipid metabolism Hepatic glycogen metabolism Promotion of tumorigenesis (Future biomarkers of MAFLD)

DPP4: dipeptidyl peptidase-4; FGF21: fibroblast growth factor 21; MAFLD: metabolic-associated fatty liver disease; mi-RNA: micro RNA; RBP4: retinol-binding protein 4; SHBG: sex hormone-binding globulin.