CK-18 and PIIINP are better at distinguishing NASH from NAFL than inflammatory factors, but CK-18 exhibits limited sensitivity (sensitivity, 60%; specificity, 97.4%); PIIINP has poor specificity (sensitivity, 80%; specificity, 68%) [31, 32]. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatohepatitis.