Further, the liver from NASH patients showed a significant decrease in the protein levels of HMGCS2 and 3-hydroxybutyrate dehydrogenase (BDH1), the latter catalyzes the interconversion of β-hydroxybutyrate and acetoacetate (Fig. 5B and S5C). This evidence concerns the gene BDH1 and metabolic dysfunction-associated steatohepatitis.