Previous studies have shown that increased fatty acid flux from adipose tissue to the liver contributes to the development of MASLD and that inhibiting ATGL may attenuate steatohepatitis.42, 43, 44 In this study, we speculate that weekly injections of tirzepatide, while increasing the expression of ATGL in adipose tissue and promoting lipolysis, result in the release of fatty acids into the circulation. The gene discussed is PNPLA2; the disease is metabolic dysfunction-associated steatotic liver disease.