PEMT and metabolic dysfunction-associated steatotic liver disease: Hepatic PC, is made from choline via the CDP-choline pathway and by PE N-methyltransferase (PEMT).58 Mice lacking Pemt exhibited liver dysfunction similar to NASH when fed a choline deficient diet where the PC:PE ratio decreases by >50%, leading to loss of membrane integrity and increased presence of hepatocyte ballooning and inflammatory response.61 Ling et al. showed that a decreased hepatic PC/PE ratio is a predictor of NAFLD and survival following partial hepatectomy.