ASAH1 and cholestasis: Regarding CER-metabolizing enzymes, subgroup analyses comparing CLI and non-CLI groups revealed that cholestasis significantly upregulated the mRNA levels of ACER3, ASAH1, GLA, B4GALT6, and SGMS2 in male patients, while in female patients, it significantly increased the mRNA levels of ACER3 and DEGS2 (Fig. 7h, Fig. S10a).