Impaired activity of fatty acid desaturase 1 and elongation of very long chain fatty acids 6, which are key enzymes in fatty acid synthesis, have been demonstrated in the liver of NASH patients, explaining the depletion of n-3 PUFAs and increased n-6/n-3 ratio that has also been reported in other lipidomic studies [4,28]. This evidence concerns the gene FADS1 and metabolic dysfunction-associated steatohepatitis.