A recent study aimed at characterizing lean Caucasian subjects with NAFLD revealed that lean-NAFLD subjects have impaired glucose tolerance and low adiponectin concentrations with an increased rate of mutant patatin-like phospholipase domain-containing 3 (PNPLA3) CG/GG variant compared to lean controls [7]. This evidence concerns the gene ADIPOQ and metabolic dysfunction-associated steatotic liver disease.