In patients with ALD&NAFLD, PNPLA3 148M alleles were associated with younger age at diagnosis of HCC (p = 0.018; p = 0.040 under a recessive model), both in cirrhotic patients in follow-up and in incident cases (p = 0.036 and p = 0.044, respectively). This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.