Genetic variations in Patatin-like phospholipase domain-containing protein 3 (PNPLA3), transmembrane 6 superfamily 2 (TM6SF2) or other genes associated with steatosis could possibly explain the association between lean NAFLD and the increased risk of future development of severe liver disease (26). This evidence concerns the gene TM6SF2 and metabolic dysfunction-associated steatotic liver disease.