Multiple studies reported that the rs738409 variant of the PNPLA3 gene was responsible factor for progression of hepatic fibrosis, NAFLD/NASH, and higher risk of emerging HCC [198-200] among Japanese [201], Hmong population (currently Hmong people principally live in countries in Southeast Asia such as Myanmar, Thailand, Vietnam, Laos, and also in Southwest China) [202], Brazil (both among whites, blacks, and pardo) [203] multi-ethnic group of Malaysia (Malay, Chinese, and Indian) [204], Thailand [205], Guatemala [206], and many other countries. This evidence concerns the gene PNPLA3 and metabolic dysfunction-associated steatohepatitis.