The role of miR-181b in NAFLD and its direct interaction with NAD-dependent deacetylase sirtuin1 (SIRT1) were examined by Wang et al. They found that human patients with NAFLD and NAFLD mouse models induced by high-fat diet (HFD) had higher miR-181b levels and lower SIRT1 levels. Here, SIRT1 is linked to metabolic dysfunction-associated steatotic liver disease.