DIAMOND mice under Western diet with sugar in drinking water that overexpressed the Pnpla3 mutant displayed more steatosis and NASH due to metabolic reprogramming, characterized by increased triglycerides, diglycerides and ceramides and downstream inflammatory pathway activation driving increased stellate cell fibrogenesis (78). The gene discussed is PNPLA3; the disease is metabolic dysfunction-associated steatohepatitis.