PEMT and metabolic dysfunction-associated steatotic liver disease: Although these clinical trials have not shown an overall clear benefit of fenofibrate on NAFLD, it could be a valuable therapeutic in a subset of NAFLD patients with a similar etiology as seen with PEMT deficiency, such as NAFLD patients with impaired VLDL secretion (i.e., abetalipoproteinemia), impaired phospholipid metabolism, or impaired methylation capacity.