SIRT1 and metabolic dysfunction-associated steatohepatitis: MiR-34a is also upregulated in serum samples of NAFLD/NASH patients, and miR-34a downregulates the expression of several key genes in NAFLD pathogenesis, including HNF4α, PPARA, and SIRT1 expressions, which are associated with higher triglycerides accumulation and liver steatosis [115].