However, PCSK9 R46L LOF variant was initially investigated to show that its carriers could have a twice elevation in the incidence rate of steatosis in the liver,194 whilst the latest findings suggested that PCSK9’s R46L variation could protect NAFLD patients from hepatic impairment.189 Although the association between PCSK9 LOF variations and NAFLD still remains unclear, PCSK9-iTs may represent a potential alternative therapy for patients diagnosed with NAFLD/NASH in the clinic. This evidence concerns the gene PCSK9 and metabolic dysfunction-associated steatohepatitis.