In keeping with the theory of impaired very-low-density lipoprotein (VLDL) secretion in NAFLD17,30, endoplasmic reticulum (ER)-associated mediators of triglyceride hydrolysis and VLDL assembly (Pnpla3, Mttp and the carboxylesterase enzymes:Ces1d,Ces1f,Ces3b) were markedly suppressed in MCDD, with Pnpla3 also suppressed in CDD. Here, MT-TP is linked to craniodiaphyseal dysplasia.