PNPLA3 and metabolic dysfunction-associated steatotic liver disease: Although the pathophysiological mechanisms underlying lean NAFLD have not been elucidated completely, it is reportedly caused by differences in visceral obesity and adipocyte differentiation, changes in lipid turnover, loss of muscle mass, genetic background such as patatin-like phospholipase domain-containing protein 3 (PNPLA3) C > G polymorphism, and different patterns of gut microflora [9].