Moreover, homozygosity for the PNPLA3 I148I variant is associated to a 10-fold increased risk of HCC related to NAFLD in the general European population (Liu et al., 2014; Eslam et al., 2018; Choudhary and Duseja, 2021), while the PNPLA3 S453I polymorfism plays a protective role (Choudhary and Duseja, 2021). This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.