A change in their metabolism and composition can lead to damaging effects on the liver.27,74 It is also thought that farnesoid X receptor (FXR), a nuclear transcription factor of which bile acids are endogenous ligands, might play a role in NAFLD due to its impact on the oxidation of lipids and affect the metabolism of cholesterol and carbohydrates.74 Furthermore, deletion of FXR leads to an increased inflammation in the liver in a WTD mice model75 and development of HCC markers induced by a bile acid (cholic acid),76 which indicates its pivotal role on the bile acid metabolism and the liver. This evidence concerns the gene NR1H4 and metabolic dysfunction-associated steatotic liver disease.