CYP20A1 and fatty liver disease: It is relatively clear that 18-HEPE is generated from EPA catalyzed by cytochrome P450 monooxygenase (CYP450) or acetylated cyclooxygenase-2 (COX-2), and as an instantaneous intermediate, it is rapidly converted into resolvin E1 (RvE1), which plays a role in improving hepatic steatosis and insulin resistance, enhancing phagocytosis of dying cells, and reducing the recruitment of immune cells secreting pro-inflammatory cytokines (Serhan and Levy, 2018; Shaikh et al., 2022; Bäck, 2023).