He found in a cohort of 628 biopsy-proven NAFLD with hyperferritinemia that ferritin, besides being significantly associated with markers of liver damage (elevated serum ALT, AST and decreased platelets) and of iron overload (iron, transferrin-iron saturation and iron stain grade), was associated with more severe histologic features of NAFLD, including steatosis, hepatocellular ballooning, increased NAFLD Activity Score (NAS) and diagnosis of NASH. This evidence concerns the gene TF and metabolic dysfunction-associated steatohepatitis.