Due to its effects on ATP level and lipid metabolism, SIRT4 has been speculated to be associated with various mitochondrial dysfunction-related pathological conditions and diseases, including type 2 diabetes (T2D), nonalcoholic fatty liver disease, diet-induced obesity, apoptosis, inflammatory vascular disease and the development of various cancers (Saunders and Verdin, 2007; Laurent et al., 2013b; Wu et al., 2014; Osborne et al., 2016). The gene discussed is SIRT4; the disease is metabolic dysfunction-associated steatotic liver disease.