PNPLA3 encodes the triacylglycerol lipase adiponutrin that mediates the hydrolysis of triacylglycerol both in the liver and in adipose tissue; the mechanisms by which the gene acts in NASH progression are still unclear, as the hepatic overexpression of PNPLA3-I148M in mice showed increased lipid accumulation but no indication of inflammation or fibrosis [90]. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatohepatitis.