ACOX1 is an enzyme primarily responsible for the oxidation of very-long-chain fatty acids in the peroxisome, and recent animal and human data supports its role in obesity, lipid metabolism, and insulin resistance.51 A liver-specific knockout of ACOX1 has been reported to promote resistance to diet-induced obesity, inflammation, and insulin resistance, further reinforcing its metabolic significance.51 Additionally, common genetic variants in ACOX1 have been associated with SBP52 and lipid levels,53 aligning with our findings. This evidence concerns the gene ACOX1 and Obesity.