Previous studies have reported that an HFD leads to increased serum DCA levels in mice, which promotes the development of hepatocellular carcinoma.48 Consuming a Western-style diet leads to an increase in Clostridium-mediated DCA, which activates FXR and subsequently causes a deficiency in Paneth cells.49 However, the regulation of bile acids by dietary cholesterol is complex, with different studies reporting varying results. Here, NR1H4 is linked to hepatocellular carcinoma.