The distribution of estrogen receptors in the liver shows distinct sexual dimorphism: females have significantly higher ERα expression in hepatocytes compared to males.[33,34] This sex difference in hepatic ERα expression may help explain why estradiol appears unrelated to steatosis in males but tends to show a protective effect in females, as lower ERα levels in males might limit estradiol’s ability to regulate lipid metabolism, while higher ERα in females could support such protective actions. The gene discussed is ESR1; the disease is steatosis.