In experimental NASH, hypoxia causes alterations in lipid homeostasis, upregulating genes involved in lipogenesis, such as SREBP-1c, PPARγ, ACC1 or 2 and downregulating genes implied in lipid metabolism, such as PPARα and carnitine palmitoyltransferase-1 (CPT-1) [153]. Here, PPARA is linked to metabolic dysfunction-associated steatohepatitis.