The frequency of G allele of the PNPLA3 rs738409 variant was significantly higher in NAFLD patients compared to those in healthy controls (OR = 1.48, 95%CI: 1.20–1.82; P = 0.00023), and PNPLA3 GC and GG genotypes were significantly associated with increased risk of disease (GC: OR: 1.52, 95%CI: 1.11–2.07; P = 0.008; GG: OR: 2.24, 95%CI: 1.41–3.55; P = 0.00055). Here, PNPLA3 is linked to metabolic dysfunction-associated steatotic liver disease.