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Figure 3. Adipose tissue-liver axis in MASH. In obesity, adipocytes release adipokines, EVs, free fatty acids, and other substances that stimulate ectopic lipid deposition in the liver, trigger inflammatory responses, and induce hepatocyte apoptosis. Hepatic injury, in turn, exacerbates adipocyte hypertrophy, impairs mitochondrial function, and drives a shift from an energy-storing to a pro-inflammatory phenotype in adipose tissue. Furthermore, it inhibits the conversion of adipocytes into brown adipose tissue, further contributing to the development of MASH. Created in BioRender. Fu R (2025) https://BioRender.com/0qyuwby. MASH: Metabolic dysfunction-associated steatohepatitis; EVs: extracellular vehicles; FGF21: fibroblast growth factor 21; FFAs: free fatty acids; FNDC4: fibronectin type III domain containing 4; IL: interleukin; TNF: tumor necrosis factor.