The distinct roles of SERPINA1 and PNPLA3 variants in the initiation and progression of liver disease were previously described by Volkert et al., in both human and experimental mouse models: the PNPLA3 polymorphism in the absence of additional metabolic risk factors is insufficient to drive the development of advanced liver disease in SERPINA1 Z allele carriers [16]. Here, PNPLA3 is linked to liver disorder.