Furthermore, leptin is strictly linked with hepatic metabolism [7] and a very recent study [8]reported a up-regulation of leptin in subjects with non-alcoholic steatohepatitis (NASH), promoting liver fibrosis by means hepatic stellate cells (HSC) via the hedgehog and the hedgehog-regulated osteopontin (OPN) pathways. Here, SPP1 is linked to metabolic dysfunction-associated steatohepatitis.