Thus, only around 12 months of age, when insulin resistance coupled with hepatocyte “dropout” stemming from progressive cardiac failure15 and consequent central venous congestion leads to the failure of these relevant hepatoprotective mechanisms, do CHIP−/−-livers finally succumb to NASH-like macrovesicular steatosis and cell injury. This evidence concerns the gene STUB1 and metabolic dysfunction-associated steatohepatitis.