The activation of STAT3 may lead to cytokine signal inhibitor-3 (SOCS-3) playing a feedback inhibitory role by weakening the leptin receptor signal transduction.55 With regard to the progression of NASH to cancer with or without cardiovascular disease, ethnicity seems to play an important role among other risk factors.56,57 SNPs in several genes have been linked with a notably increase of the risk to develop hepatocellular carcinoma (HCC).56 Variants in PNPLA3, TM6SF2, MBOAT, and GCKR seem to be highly relevant. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatohepatitis.