Genetic Susceptibility Versus Fibrosis Progression in North Indian Metabolic Dysfunction-Associated Steatotic Liver Disease: Distinct Roles of APOC3 and PNPLA3 in a Candidate Gene Study.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 30-38% of Indian adults, yet the contribution of genetic risk variants to disease susceptibility and fibrosis progression remains poorly characterised. We investigated 12 candidate single-nucleotide polymorphisms (SNPs) in North Indian patients, benchmarking allele frequencies against IndiGenomes and global populations. Methods: = 31). Allele frequencies were compared with IndiGenomes (∼1020 Indian individuals) and 1000 Genomes populations. Results: = 1.000), suggesting a role in susceptibility rather than progression. Conclusion: rs738409 is associated with fibrosis severity within established disease. These hypothesis-generating findings support ancestry-specific approaches to genetic risk stratification in Indian MASLD.