Another retrospective study of 1286 patients who underwent liver biopsy at an Italian centre reported that HCC did occur in a NAFLD-only cohort in the absence of metabolic dysfunction (defined using the MAFLD definition, albeit without waist circumference or CRP data), but who had genetic predisposition with high-risk alleles of PNPLA3 and TM6SF2. Here, PNPLA3 is linked to hepatocellular carcinoma.