However, we did not observe an association between flavonolignan metabolic ratios and bilirubin in patients within the same UGT1A1 genotype group which suggests the influence of UGT1A1*28 polymorphism on silymarin metabolism in HCV-infected or NAFLD patients may be masked by a greater effect of disease state. This evidence concerns the gene UGT1A1 and metabolic dysfunction-associated steatotic liver disease.