There is very robust evidence for this genetic polymorphism for its association with NASH cirrhosis since it was first described in 2008.14 Some researchers consider this PNPLA3-associated NASH to be a distinct entity from the common NAFLD that we encounter in patients with multiple metabolic risk factors.15 This genetic polymorphism has been described in patients with NAFLD worldwide including South Asia. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatohepatitis.