PNPLA3 and metabolic dysfunction-associated steatotic liver disease: Obesity and insulin resistance are strongly associated with MASLD, mostly through increased delivery of free fatty acids to the liver and increased hepatic lipogenesis associated with hyperglycemia and hyperinsulinemia.9,10 Other contributory factors are divided into those with an established association with MASLD, including genetic factors (e.g. polymorphism of patatine-like phospholipase domain-containing protein 3 gene),11 dietary factors (e.g. fructose),12,13 and adipokines,10 as well as those with a potential association needing validation, including dysbiosis of the gut microbiota.