Although a single marker is likely to be insufficient to fully encompass the complexity of NAFLD pathogenesis, this translational study reveals that AAA-1 promote hepatocyte lipogenesis through SREBP-1 activation and foster inflammation and damage in hepatic cells, lending weight to the hypothesis that AAA-1 may be a pathogenic driver of NAFLD. Here, NPSR1-AS1 is linked to metabolic dysfunction-associated steatotic liver disease.