The pathogenesis of alcohol fatty liver is complex, but the essence is mainly through the influence of alcohol dehydrogenase (ADH) (70–80%) and cytochrome P4502E1 (CYP2E1) enzyme activity [78] of microsomal ethanol oxidation system (MEOS) (10–25%), influence of ethanol metabolism; ADH enzyme activity [79] regulates lipid metabolism by affecting SIRT1 [80], AMPK [79], SREBP-1C, ChREBP, and PPAR-α. The gene discussed is AKR1A1; the disease is Hepatic steatosis.