Currently, there is no consensus regarding the NAFLD evaluation and management algorithm, although serum, genetic or imaging parameters, even some of them, were considered effective (gamma-glutamyl transferase, elastography, probiotics/prebiotics) or having unclear effectiveness (cytokeratin 18, cathepsin D, interleukin-6, patatin-like phospholipase domain-containing protein 3- PNPLA3, adipokine, hepatokine) [4,6,19,25,26]. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatotic liver disease.