Interestingly, a strong inverse correlation was found between P1-IgM levels and monocyte chemoattractant protein-1 (MCP-1; Pearson R: −0.39, p = 0.0006, Fig. 4g), IL-6 (Pearson R: −0.24, p = 0.041, Fig. 4h), and cathepsin D (Pearson R −0.25, p = 0.0033, Fig. 4I), which we recently validated as a marker for pediatric NASH. Here, CTSD is linked to metabolic dysfunction-associated steatohepatitis.