Patatin-like phosphatase domain-containing 3 genotype and quality of dietary fat modify the liver adiposity in men.

Milla-M Tauriainen, Maria A Lankinen, Juhana M Hakumäki, Olli M Lahtinen, Minna Husso, Jyrki J Ågren, Markku Laakso, Ursula S Schwab

Journal: European journal of nutrition 2026;65(5):

PMID: 42371130

Abstract

BACKGROUND

Patatin-like phosphatase domain-containing 3 (PNPLA3) gene and dietary fat are important factors for metabolic dysfunction-associated steatotic liver disease (MASLD).

OBJECTIVE

We studied the impact of dietary fat quality modification on liver adiposity in men homozygotes for PNPLA3 (GG, carriers of the risk allele and CC, non-carriers).

METHODS

Ninety-eight men (age: 67.8 ± 4.2 years, body mass index: 27.2 ± 2.5 kg/m2), homozygous for PNPLA3 rs738409 variant (I148M), randomly assigned for two diet intervention arms, participated in a 12-week diet intervention. Recommended diet (RD) arm ate fat according to the National and Nordic nutrition recommendations, average diet (AD) arm ate according to the average fat intake in Finland. Liver imaging by ultrasound with 2D-shear wave elastography (2D-SWE) and magnetic resonance imaging (MRI) in combination with magnetic resonance spectroscopy (MRS) were performed.

RESULTS

MRI-based liver fat proportion decreased in the RD arm (CC: from 3.8 ± 3.2 to 3.2 ± 3.3%, GG: from 3.9 ± 3.3 to 3.5 ± 3.1%, p time = 0.032) and increased in the AD arm (CC: from 4.1 ± 3.6 to 4.8 ± 3.9%, GG: from 4.7 ± 3.7 to 6.7 ± 5.3%, p time = 0.015). MRS-quantified liver saturated fat content increased in the AD arm in both genotypes of PNPLA3 (p time = 0.010). Liver triglyceride concentration did not change in either arm with the CC genotype but increased in the AD arm with the GG genotype (for time and genotype interaction p = 0.027).

CONCLUSION

Diet based on fat quality recommendations could be beneficial for liver health in both PNPLA3 genotypes CC and GG. The average diet seems to be especially harmful for liver health in carriers of the PNPLA3 risk genotype (GG).

© 2026. The Author(s).

Address: Unit of Endoscopy, Department of Medicine, Kuopio University Hospital, North Savo Wellbeing County, Finland. [email protected].; School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, North Savo Wellbeing County, Finland.; Institute of Clinical Medicine, Unit of Radiology, University of Eastern Finland, North Savo Wellbeing County, Finland.; Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, North Savo Wellbeing County, Finland.; Institute of Clinical Medicine, Unit of Radiology, University of Eastern Finland, North Savo Wellbeing County, Finland.; Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, North Savo Wellbeing County, Finland.; HUS Diagnostic Center, Helsinki University and Helsinki University Hospital, Helsinki, Finland.; Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.; Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland.; Department of Medicine, Kuopio University Hospital, North Savo Wellbeing County, Finland.; School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.; Department of Medicine, Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, North Savo Wellbeing County, Finland.
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