Several mechanisms might account for the inhibition of Foxa1 in NAFLD, including direct repression of Foxa1 via deregulation of the protein kinase C pathway [29] and down-regulation of CCAAT/enhancer binding protein beta (C/EBPβ) [34] or an indirect mechanism via inhibition of the TGF-beta signaling pathway by hepatocyte nuclear factor 6 (HNF-6) [35] or deregulation of miR-122/FOXA1/HNF4a feedback loop [36]. Here, HNF4A is linked to metabolic dysfunction-associated steatotic liver disease.