A study on NAFLD demonstrated significant reductions in PPARα and its downstream critical enzymes, including acyl-CoA oxidase 1 (ACOX1) and carnitine palmitoyltransferase 1A (CPT1A), as well as the fatty acid oxidation product β-hydroxybutyrate (β-HB), in TET1 knockout mice. This evidence concerns the gene ACOX1 and metabolic dysfunction-associated steatotic liver disease.