Epigenetic modifications such as an altered promoter methylation of the hepatic energy regulator PPARγ coactivator 1 alpha (PGC1α) or changes in the expression of the hepatic micro-RNAs (e.g. miR-122), are predicted to be further major determinants of NAFLD disease progression [69]. The gene discussed is PPARGC1A; the disease is metabolic dysfunction-associated steatotic liver disease.