Furthermore, although the association between PNPLA3 genotype and adiponectin was independent of steatosis severity in patients with NAFLD, our results does not exclude that PNPLA3 may modulate adipose tissue indirectly by regulating the secretion of hepatokines such as fetuin [40], and that it may also modulate other pro-inflammatory molecules such as resistin and ICAM-1 [26,41]. This evidence concerns the gene ADIPOQ and metabolic dysfunction-associated steatotic liver disease.