One of the strongest and most studied genetic risk factors for NAFLD worldwide is the single nucleotide polymorphism (SNP) rs738409 C > G in PNPLA3, which encodes the protein variant I148M, and has been associated with hepatic steatosis and fibrosis progression in children and adults.54, 55. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.