Failure to increase the number of secreted VLDL particles could indicate suboptimal apoB100 levels as a precipitating factor in NAFLD, and while mRNA levels of apoB100 and MTTP was found to be higher in patients with NAFLD compared to controls [35, 121], apoB100 synthesis rates were lower in patients with NASH (n = 7) compared to lean (n = 7) or BMI-matched obese (n = 7) controls without NASH [122]. This evidence concerns the gene MTTP and metabolic dysfunction-associated steatohepatitis.