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At the transcriptional level, many of the genes whose expression is altered in NAFLD such as genes regulating lipid synthesis (eg, acetyl-CoA carboxylase 1 , fatty acid synthase , diacylglycerol o-acyltransferase) and mitochondrial -oxidation (eg, long-chain acyl-CoA dehydrogenase , hydroxyacyl-CoA dehydrogenase trifunctional multienzyme complex subunit alpha , UCP2 , acyl-CoA oxidase ) are upregulated, potentially as a secondary compensatory mechanism to respond to the increased flow of substrate due to calorie overload

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