On top of that, the upregulation of AOX1 and P47PHOX suggests oxidative damage (Li et al., 2019), and exercise was sufficient to downregulate these genes when NASH was present; however, the change in diet combined with exercise (group 5) was not sufficient to decrease AOX1 activity and actually enhanced it. This evidence concerns the gene AOX1 and metabolic dysfunction-associated steatohepatitis.