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When NAFLD was stratified by NFS, subjects with advanced liver fibrosis exhibited a higher prevalence of diastolic dysfunction (49.0%, 50.7%, 61.8%

doi: 10.3389/fmed.2022.963435 5

doi: 10.1080/15548627.2022.2061756 54

Leaky gut may also stem from systemic inflammation, where cytokines like interleukin (IL)1, IL-6, tumor necrosis factor (TNF)-, and interferon (IFN)- disrupt gut permeability and promote bacterial translocation by weakening tight junctions [21]