PNPLA3 and metabolic dysfunction-associated steatotic liver disease: Carriers of the genetic variant p.I148M (rs738409 C/G) in PNPLA3 gene have a higher risk of liver damage in the presence of external noxious, raised levels of aspartate aminotransferase and/or alanine aminotransferase,93 and more severe NASH with greater levels of fibrosis.94,95 PNPLA3 gene is recognized as a modifier in terms of NAFLD disease severity and risk of related hepatocarcinoma,96 but is not associated with insulin resistance97 and has apparently no significant effect on NAFLD-related CVD risk.98–100