The significant association between increased levels of plasma HMGB1 and a higher degree of liver fibrosis in the recent pediatric study highlighted its biomarker potential for non-invasive diagnosis of NASH.[23] However, in the current study, we failed to show any significant relationship between serum HMGB1 levels and degree of liver fibrosis or histologic severity in either children or adults with biopsy-proven NAFLD. This evidence concerns the gene HMGB1 and metabolic dysfunction-associated steatohepatitis.