Representative MRI-PDFF and MRE of a pair of 60 year old male twins concordant for both NAFLD (MRI-PDFF ≥5%) and hepatic fibrosis (MRE >3 kPa). Hepatic steatosis and fibrosis have significant shared gene effects with one another at 0.756 (95% CI: 0.716, 1), p=2.54e-5. Hepatic steatosis also has significant shared gene effects with BMI, systolic blood pressure, diastolic blood pressure, HDL cholesterol, triglycerides, glucose, HOMA-IR, insulin, and hemoglobin A1c, and hepatic fibrosis has significant shared gene effects with BMI, HDL cholesterol, triglycerides, glucose, HOMA-IR, insulin, and hemoglobin A1c.