Although the exact role of miR-34a in NAFLD development remains largely unknown, because miR-34a was shown to directly target and suppress SIRT1 expression29, it is probable that aberrant increase in hepatic miR-34a expression may act to lower hepatic SIRT1 level30 and thereby to facilitate NAFLD development. Here, SIRT1 is linked to metabolic dysfunction-associated steatotic liver disease.