PNPLA3 and Insulin resistance: These FFAs are subsequently converted to hepatic triglycerides, which causes hepatic steatosis (19).However, FFAs also cause hepatic and peripheral insulin resistance, and insulin resistance feeds the vicious cycle by causing more hepatic FFAs to build up (20).It is noteworthy to emphasize that interactions between genes and the environment appear to be essential for hepatic steatosis (20).For instance, there is a high correlation between variations in liver fat content and variations in the patatin-like phospholipase domain-containing 3 (PNPLA3) gene.