Histological NASH was found to be predicted by a combination of four ELISA-based tests – cleaved CK-18, a product of the subtraction of cleaved CK-18 level from intact CK-18 level, serum adiponectin and serum resistin – with a sensitivity 96%, specificity of 70% and AUROC of 0.91.139 CK18 fragment has also been combined with ALT levels and the presence of the metabolic syndrome in the ‘Nice model’, a composite model where AUROCs of 0.83–0-88 were demonstrated for the diagnosis of NASH, as defined by a NAS score ≥5, in a morbidly obese population.140. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatohepatitis.