Of note, individuals with SIRD were more frequently carriers of the G allele of rs738409 in PNPLA3, the gene encoding patatin-like phospholipase domain-containing-3, which is characterised by its positive association with hepatic fat content [43] and may contribute to the relationship between SIRD and progression of NAFLD to fibrosis [6, 26, 29]. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.