Several signaling pathways such as hypoxia inducible factors (HIF), peroxisome proliferator-activated receptors (PPAR) and phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) might contribute to HK2 induction in fatty liver disease and its evolution towards cirrhosis and carcinogenesis35–37. Here, PPARA is linked to fatty liver disease.