However, after conducting an area under the receiver operating characteristic curve (AUROC) analysis the of top 20 lipids as determined by random forest analysis, adjusting for age, sex, diabetes, metabolic syndrome, and PNPLA3 genotype, no single lipid was able to predict NAFLD status better than 71% (Additional file 4). This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.