On the other hand, chronic endoplasmic reticulum stress exacerbates NAFLD progression by stimulating lipogenesis, restricting very-low-density lipoprotein production, and enhancing insulin resistance via unfolded protein response pathway activation, with PERK-mediated Nrf2 phosphorylation offering antioxidant defense [132]. The gene discussed is EIF2AK3; the disease is metabolic dysfunction-associated steatotic liver disease.