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Adiponectin has antilipogenic and anti‐inflammatory effects, while tumor necrosis factor α (TNF‐α) reduces insulin sensitivity and has proinflammatory effects. We examined (1) the extent to which hypoadiponectinemia and TNF‐α activation are features of nonalcoholic steatohepatitis (NASH) and (2) whether serum levels of these markers correlate with the severity of histological changes in 109 subjects with nonalcoholic fatty liver disease (NAFLD), including 80 with NASH and 29 with simple steatosis. By multivariate analysis, subjects with NASH had reduced adiponectin level and increased TNF‐α and soluble TNF receptor 2 (sTNFR2)—but not leptin levels, compared with controls matched by age, sex, and body mass index; these differences were independent of the increased insulin resistance (by homeostasis model [HOMA‐IR]) in NASH. When compared with simple steatosis, NASH was associated with lower …