To address this, we perform a quantitative analysis within a well-characterized European Caucasian ‘discovery’ cohort with histologically characterized NAFLD, controlling for relevant co-morbidities and factors that have previously been linked with disease progression (age, gender, body mass index (BMI), presence of T2DM and PNPLA3 rs738409 genotype), and replicate our findings in a separate histologically characterized European Caucasian ‘validation’ cohort. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.