Expression heatmap revealed that 22 of 25 differentially expressed lipid-related genes were over-expressed in NASH liver samples compared to healthy obese liver samples and three were down-regulated (PPARA, PPARGC1A, and CNPB) associated with misclassification error rate of 16.6% (Figure 2C). This evidence concerns the gene PPARA and metabolic dysfunction-associated steatohepatitis.