Previously, Nishioji et al. investigated 391 Japanese aged 35–75 years with BMI 18.5–22.9 kg/m2 and showed a significant association between AWG ≥ 10 kg and NAFLD (OR, 2.62; 95% CI, [1.32, 5.23]; p = 0.0059) after adjusting for the effects of age, sex, PNPLA3 rs738409 polymorphism, hypertension, type 2 diabetes mellitus, and dyslipidemia [28]. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.