Of note, patient #1 had compensated NASH and only moderate systemic classical or alternative RAS activity, and exhibited the highest hepatic activity of the classical RAS (ACE activity: 286.0 (pg Ang II/μg protein)/h; chymase activity: 6971.0 (pg Ang II/μg protein)/h) and ACE2 (186.0 (pg Ang 1–7/μg protein)/h), while NEP activity was the lowest among all patients (59.0 (pg Ang 1–7/μg protein)/h). Here, ACE is linked to metabolic dysfunction-associated steatohepatitis.