Conversely, alterations in the expression or activity of specific epigenetic enzymes, such as DNA methyltransferases (DNMTs), histone acetyltransferases (e.g., p300/CBP), histone deacetylases (e.g., HDAC3, SIRT1), and histone methyltransferases (e.g., EZH2), can create a hepatic microenvironment that promotes MASLD progression and tumor development. The gene discussed is SIRT1; the disease is neoplasm.