Mitochondrial respiration is required for cuproptosis, but upregulation of mitochondrial activity often occurs in an early NAFLD stage, and the expression levels of cuproptosis-related genes (DLD and PDHB) are increased in our study, which suggests that cuproptosis may contribute to the progression of NAFL to NASH [7, 22]. This evidence concerns the gene DLD and metabolic dysfunction-associated steatohepatitis.