Recently, individuals with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD), disorders both associated with lipodystrophy, were also found to have a ZMPSTE24 missense mutation (Table 1) (Brady et al., 2018; Dutour et al., 2011; Galant et al., 2016). This evidence concerns the gene ZMPSTE24 and metabolic dysfunction-associated steatotic liver disease.