In this process, estrogen-related receptor alpha (ERRα) is a critical modulator in the downstream of estrogen/ERα signaling, particularly influencing hepatic very low-density lipoprotein (VLDL) assembly and secretion, with its dysfunction leading to hepatosteatosis and potential progression to NAFLD, especially in men and postmenopausal women (16). Here, ESRRA is linked to metabolic dysfunction-associated steatotic liver disease.