Lastly, it has been suggested that the liver plays a role in downregulating the circulation of very-low-density lipoproteins, increasing the expression of TSC22 domain family member 4 (TSC22D4), inhibiting lipogenesis, causing hepatic steatosis, and potentially stimulating liver gluconeogenesis, further increasing energy expenditure [83,84]. This evidence concerns the gene TSC22D4 and fatty liver disease.