Risk factors of rapid fibrosis progression in NAFLD includes the existence of NASH [120], age [2,120], severe obesity [117,121,122], high fructose consumption [123], insulin resistance [3], presence of T2D [2,17], high HbA1c levels [124], menopause in women [125,126], high ALT levels [127,128], and PNPLA3 G allele [129]. The gene discussed is PNPLA3; the disease is obesity due to melanocortin 4 receptor deficiency.