Xie et al. found that renal-specific oxidoreductase/myo-inositol oxygenase (RSOR/MIOX) in DN could cause NADH/NAD+ imbalance, thereby activating the PKC-α and MAPK signaling pathways, promoting TGF-β secretion and fibronectin deposition, and driving tubulointerstitial fibrosis [25]. Here, MIOX is linked to fibrosis.