These factors were divided into three categories (Figure 1), such as individual characteristics (age, sex, ethnicity, diet and physical activity, alcohol consumption, and microbiota composition), metabolic factors (body mass index (BMI) and visceral adiposity, diabetes, hypertension, and dyslipidemia), and genetic/epigenetic factors (SNP in patatin-like phospholipase domain-containing 3 (PNPLA3) p.I148M and transmembrane 6 superfamily member 2 (TM6SF2) p.E167K, which have been shown to increase MASLD progression along with metabolic health and individual characteristics). This evidence concerns the gene PNPLA3 and metabolic syndrome.