PEMT and metabolic dysfunction-associated steatotic liver disease: It has been mentioned that during hepatocyte injury, phosphatidylethanolamine-N-methyltransferase (PEMT) activity declines, which increases the disease severity and leads to reduced synthesis of PC.26 Subjects detected with PEMT functional single nucleotide polymorphism are prone to developing NAFLD.52 Phosphatidylcholine may also be depleted through adaptation to SM and diacylglycerol production.53 Ether-phospholipids are the byproducts of the liver.