The third and final cluster appeared to reflect the interplay between hepatocyte biology and fat distribution with top loci including a missense variant in SERPINA1 and SHBG—the former is known to cause alpha-1-antitrypsin deficiency and has been previously associated with increased ALT and cirrhosis, and sex-hormone binding globulin is synthesized by hepatocytes and is reduced in patients with non-alcoholic fatty liver disease57,58. Here, SERPINA1 is linked to Cirrhosis.