PNPLA3 and fatty liver disease: A similar approach has been used in a cohort of 2042 pediatric patients by Suomela and collaborators, who confirmed that the combination of genetic and metabolic risk factors, along with BMI, insulin levels and, PNPLA3 and TM6SF2 genetic variants, in a predictive score is more trustworthy to foresee fatty liver compared to the one used in adulthood based only on BMI and insulin [239].