In the NAFLD model of zebrafish, we observed that swimming exercise can inhibit excessive ROS production, reduce caspase-3 and Bax expression, and increase Bcl-2 levels by activating recombinant Sirtuin 1 (SIRT1)/AMP-activated protein kinase (AMPK) signaling-mediated NRF2, which in turn reduces oxidative stress and ROS-induced apoptosis in zebrafish liver, decreases lipid accumulation in zebrafish NAFLD model liver, and attenuates liver injury [31]. Here, PRKAA1 is linked to metabolic dysfunction-associated steatotic liver disease.