The increased TXNIP protein binds to and inhibits the degradation of CCAAT/enhancer-binding protein homologous protein (CHOP), which is a major transcriptional regulator of ER stress-mediated apoptosis and has been reported to regulate apoptosis, inflammation, and fibrosis in NASH 36-39. Here, DDIT3 is linked to metabolic dysfunction-associated steatohepatitis.