Therefore, these data are thought to be inconsistent with the ‘multiple parallel-hit hypothesis,’ while the findings above appear to support the ‘two-hit hypothesis’ as lacking Lrat has no effect on the ‘first hit’ but exerting suppressive effects on the ‘second hits.’ This we propose contributes to suppressed development of NASH-related liver tumorigenesis we have observed. Here, LRAT is linked to metabolic dysfunction-associated steatohepatitis.