Moreover, except for NOX4 expression, which trended lower, NFE2L2, NQO1, SOD2, and CAT gene expression declined in patients with obesity (BMI = 47–74) with NASH and fibrosis (NAS = 5–6; fibrosis score = 1–2) to levels evident in patients with obesity with nonsteatotic livers (Figure 1B). This evidence concerns the gene NOX4 and obesity due to melanocortin 4 receptor deficiency.