The majority of FCS cases (around 95%) are associated with specific pathogenic variants of the lipoprotein lipase (LPL) gene, and 5% of FCS cases are linked to variants in four other genes (APOC, APOA5, LMF1, and GPIHBP1), encoding proteins that modulate the activity of LPL (4, 5) Multifactorial chylomicronemia syndrome (MCS) is a common cause of severe hypertriglyceridemia, linked to risks of acute pancreatitis, cardiovascular issues, and non-alcoholic steatohepatitis. Here, LPL is linked to metabolic dysfunction-associated steatohepatitis.