The observation that CEC was not impaired in patients where fatty liver was due to PNPLA3 variant, which exhibited a hepatic fat content that was almost superimposable to that observed in patients with metabolic NAFLD, it is strongly supportive of the conclusion that the excess of hepatic fat, per se, did not impair HDLs functionality. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.