EPAS1 and obesity due to melanocortin 4 receptor deficiency: Additionally, activation of intestinal hypoxia-inducible factor 2a (HIF-2a) during obesity has been demonstrated to contribute to hepatic steatosis by promoting Cers/DHCers accumulation, mainly due to the degradation of complex sphingolipids in the so-called salvage pathway [36], including a variety of HexCers, which, in the present study, were (not surprisingly) decreased (e.g., HexCers 22:0 and 24:0), suggesting a diversion towards Cers/DHCers conversion.