Since PNPLA3 has been recognized as a genetic determinant of liver fat content in patients with both NAFLD[13,14,15,16] and alcoholic liver disease[34,35], it was hypothesized that this SNP is also associated with steatosis and fibrosis progression in patients with chronic hepatitis C. Although previous studies reported a positive correlation between the PNPLA3 genotype and steatosis or fibrosis progression in patients with chronic hepatitis C[19,20], this correlation was controversial due to their cross-sectional study design. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.