PNPLA3 and metabolic dysfunction-associated steatotic liver disease: These genetic polymorphisms are genes implicated in the regulation of lipid accumulation in hepatocytes, oxidative stress, insulin resistance and fibrogenesis A high-frequency gene variant in MASLD is the PNPLA3 (Patatin-like phospholipase domain-containing protein 3) allele rs738409[G] (43).