Compared with healthy subjects, patients with NAFLD exhibit increased CpG methylation in fatty acid oxidative genes and decreased methylation in fibrogenic genes, which may collectively contribute to the initiation and progression of NAFLD.[24] Moreover, analysis of liver biopsy samples from a cohort of NAFLD patients showed that methylation levels at the promoter of the fatty acid oxidative gene PGC1α was negatively associated with its gene expression and positively associated with insulin resistance.[25]. The gene discussed is PPARGC1A; the disease is metabolic dysfunction-associated steatotic liver disease.