SIRT4 and metabolic dysfunction-associated steatotic liver disease: SIRT2 appears to have a deleterious effect on hepatic fibrosis via the SIRT2/ERK/c-Myc axis.675 Moreover, in both NAFLD and alcoholic fatty liver disease mouse models, liver-specific SIRT3 knockdown alleviated alcoholic feeding-induced liver injury and lipid accumulation, which was associated with improved autophagy induction.676,679 In addition, SIRT4 might have harmful effects on NAFLD, and its molecular mechanism may be partly associated with deacetylating and destabilizing mitochondrial trifunctional protein-α.661