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Experimental and clinical studies provided evidence for a critical role of macrophages in NAFLD development and progression. Especially, liver\u2010resident macrophages (also known as Kupffer cells) are likely the common final pathway of several pro\u2010steatosic signals. A huge amount of danger\u2010associated molecular patterns recognized by Kupffer cells is provided within the liver by lipid and glucose toxicity. Other pro\u2010inflammatory signals come from surrounding tissues into the portal vein, directly to the liver: they come from dysfunctional adipocytes, adipose tissue macrophages and gut dysbiosis. These complex crosstalks are differently represented across sexes, as sexual hormones control many of these processes. Sexual dimorphism then modulates metabolic and inflammatory cascades driving the liver from a simple steatosis to NAFLD and beyond. Here, metabolic and inflammatory mechanisms underlying NALFD pathophysiology will be updated. A special attention will be paid to describe sex\u2010related differences that could provide insights for patient stratification and more tailored therapeutic approaches.<\/jats:p>","DOI":"10.1111\/eci.13236","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T17:58:50Z","timestamp":1586973530000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Macrophages in the pathophysiology of NAFLD: The role of sex differences"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4358-6411","authenticated-orcid":false,"given":"Stefano","family":"Ministrini","sequence":"first","affiliation":[{"name":"Internal Medicine Department \u201cSanta Maria della Misericordia\u201d Hospital University of Perugia Perugia 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