PNPLA3 and metabolic dysfunction-associated steatotic liver disease: 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.