Due to overstimulation or chronic activation, nrf2 may convert its cytoprotective effects into cytotoxicity, leading to an imbalance in the antioxidant system (e.g., decreased levels of the antioxidant enzymes SOD, CAT, and GSH-Px, and an increase in MDA) and ultimately exacerbating MASLD. Here, SOD1 is linked to metabolic dysfunction-associated steatotic liver disease.