ACLY and hyperinsulinemic hypoglycemia, familial, 4: It revealed that expression of lipid biosynthetic genes, including acetyl CoA synthetase long-chain family member 1, lipin 1, diacyl-glycerol O-acyltransferase 2, and ATP citrate lyase were increased, suggesting increased lipid biosynthesis under folate deficiency (Fukuoka and Kubota, 2018).