Previous clinical trials have shown that Pioglitazone, a PPARγ agonist, can improve hepatic steatosis in NAFLD patients but does not affect NASH or liver fibrosis.38 Our findings suggest that PPARγ may only regulate the transcription of ATGL but not CGI-58, which may explain why Pioglitazone is ineffective in treating NASH and liver fibrosis. Here, PNPLA2 is linked to metabolic dysfunction-associated steatohepatitis.