Whether reduced AKR1D1 activity contributes to the pathogenesis of metabolic disease is almost entirely unexplored, however, we have recently shown that manipulating AKR1D1 alters glucocorticoid and bile acid regulation of metabolism and inflammation in vitro (Nikolaou et al. 2019a, b, 2020). The gene discussed is AKR1D1; the disease is metabolic disease.