This coincides with the latest proposal that the American Diabetes Association guidelines in 2022 have proposed PPARγ agonists (pioglitazone) and glucagon-like peptide-1 (GLP1) receptor agonists for treating diabetes, NAFLD, or NASH [16, 29], in response to global health threats, possibily because Menin/SIRT1 mediated PPARγ acetylation plays a crucial role in orchestrating adipose plasticity and metabolic rhythms [19]. Here, SIRT1 is linked to metabolic dysfunction-associated steatotic liver disease.