Although our patient cohort is relatively small (n = 26) compared to other previous studies, serum liver enzymes such as ALT and AST (Table 1) are consistently increased in NASH patients with the PNPLA3 genetic variant along with the steatosis grade, inflammation, ballooning and NAS score, compared to the C/C carriers (Table 2). This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatohepatitis.