Insulin resistance within the liver as well as extra-hepatic tissues such as adipose and skeletal muscle is implicated in the pathogenesis of NAFLD, however there are emerging data describing hepatic steatosis occurring in the absence of insulin resistance, particularly in individuals with single nucleotide polymorphisms within the PNPLA3 gene that encodes the enzyme, patatin-like phospholipase 3 [52]. This evidence concerns the gene PNPLA3 and Insulin resistance.