In NAFLD patients (F0–F3) with HCC, serum YKL-40 levels were significantly higher than in those without HCC (mean 309.5 ± 86.7, 143.2 ± 94.8 respectively, P < 0.0001) (Fig. 4a). Here, CHI3L1 is linked to metabolic dysfunction-associated steatotic liver disease.