Female sex and oestrogens also appear protective against NAFLD related fibrosis [59] and thrombopoietin levels are higher in obese women [60], potentially resulting in stimulated thrombopoiesis, which would explain the positive association of BMI with PLT [10] and may be preventing an inverse interaction of PLT with obesity in UK Biobank women. This evidence concerns the gene THPO and obesity due to melanocortin 4 receptor deficiency.