The pathophysiology and severity of steatohepatitis, a cause of portal hypertension, appear to result from a complex interplay of genetic factors (such as polymorphisms in PNPLA3, TM6SF2, MBOAT1, or HSD17B13), associated comorbidities (including obesity, type 2 diabetes mellitus, and gut dysbiosis), as well as environmental and behavioral influences (such as socioeconomic status, diet, and physical activity) [31,32,33,34,35,36,37]. This evidence concerns the gene PNPLA3 and portal hypertension.