Indeed, Pacifico et al. 20 also demonstrated that in a study of Caucasian children highest TG:HDL-C ratio showed a 1.8- to 3.8-fold increased risk of central obesity, insulin resistance, high-sensitivity c-reactive protein, non alcoholic fatty liver disease, metabolic syndrome, and increased carotid artery intima-media thickness. This evidence concerns the gene CRP and metabolic dysfunction-associated steatotic liver disease.