Although only 1 of these genes had been linked to the Hedgehog pathway previously, remarkably, each encodes a factor that has been shown to exert protective effects that impede evolution of NAFLD or MetS.43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76 For example, hepatocytes with Smo activity express significantly higher levels of MAT1-A and ALDH6A1 than Smo-KO hepatocytes. Here, ALDH6A1 is linked to metabolic dysfunction-associated steatotic liver disease.