PNPLA3 and metabolic dysfunction-associated steatotic liver disease: Along these lines, our data on 471 biopsy-proven NAFLD patients followed-up for a median period of 64.6 months showed that 13 patients (2.7%) developed HCC and all of them had F3–F4 fibrosis, was independently associated with HCC occurrence, together with the PNPLA3 G > C variant in the multivariate analysis [30].