Many scoring systems to differentiate NAFL and NASH have been reported, including FIB-4 score (age×AST/platelet×ALT), AST to ALT ratio, BARD score (BMI > 28, AST/ALT > 0.8, diabetes), APRI score (AST to platelet ratio), Fibro test (includes total bilirubin, gamma GTP, alpha 2 macroglobulin, apolipoprotein A1, haptoglobulin), cytokeratin 18 (CK-18) fragments, hyaluronic acid, soluble Fas and Fas ligand, C-reactive protein, fibroblast growth factor-21, adiponectin, and desmosterol [58,59]. This evidence concerns the gene KRT18 and diabetes mellitus.