Multiple studies screening for LAL mutations in NAFLD patients with low LAL activity did not find any (Vespasiani-Gentilucci et al., 2016; Gravito-Soares et al., 2019), and there are currently no GWAS reporting associations of NAFLD or other hepatic phenotypes with LIPA variants in the NHGRI-EBI GWAS catalog (Buniello et al., 2019), so it does not appear to be a gene polymorphism effect. This evidence concerns the gene LIPA and metabolic dysfunction-associated steatotic liver disease.