Since palmitate is the most abundant saturated fatty acid in serum of NAFL patients and its serum levels are further increased in NASH patients5,36, we postulated that the overload of palmitate may result in the upregulation of Acer3/ACER3 in hepatocytes during progression of NAFL to NASH. This evidence concerns the gene ACER3 and metabolic dysfunction-associated steatohepatitis.