Factors leading to NAFLD include insulin resistance, excessive lipid accumulation and increased activation of lipid signaling resulting in cellular distress, the activation of natural immunity, a microbiome with genetic susceptibility (PNPLA3 gene), and an unhealthy diet (saturated fatty acids and fructose) and physical inactivity [140]. The gene discussed is PNPLA3; the disease is metabolic dysfunction-associated steatotic liver disease.