Located in the upper reaches of the SIRT3/FoxO3 pathway, miRNA-421 can directly recognize and inhibit the expression of SIRT3/FoxO3 protein, resulting in the decrease of MnSOD and CAT, the downstream targets of SIRT3/FoxO3, and the increase of fat accumulation and triglyceride levels in adipocytes, thus participating in the oxidative damage of NAFLD [150]. Here, FOXO3 is linked to metabolic dysfunction-associated steatotic liver disease.