Such crystals have been shown to distinguish between steatosis and NASH in humans and mice (Ioannou et al., 2013; Ioannou et al., 2017; Ioannou et al., 2019), coincide with increased cholesterol, and appear to nucleate at lipid droplets and stimulate NLR family pyrin domain containing 3 (NLRP3) inflammasome activity. This evidence concerns the gene NLRP3 and metabolic dysfunction-associated steatohepatitis.