Genetic variations in PNPLA3, transmembrane 6 superfamily 2 (TM6SF2), membrane-bound O-acyltransferase domain-containing 7 (MBOAT7), or other genes associated with hepatic steatosis may possibly explain the relationship between lean NAFLD and the increased future risk of developing severe liver disease or RFS in HCC. This evidence concerns the gene PNPLA3 and hepatocellular carcinoma.