PNPLA3 and metabolic dysfunction-associated steatotic liver disease: Although other authors showed that higher NAFLD activity scores were associated with a variant in farnesyl diphosphate farnesyl transferase 1, an enzyme with a role in cholesterol biosynthesis [18], PNPLA3 represents the only gene that has been consistently identified across multiple GWAS as a potential modifier of both hepatic TG accumulation and clinical biochemistry indices as raised serum alanine aminotransferase (ALT) levels.