Also, the gene set enrichment analysis using the KEGG database in NASH patients with high MMP9 expression levels significantly identified ECMR pathways (NES = +2.14, p-value <0.0001; Fig. 5F, Supplementary Dataset 4) as shown by the unsupervised cluster analysis and represented by the associated heatmap. Here, MMP9 is linked to metabolic dysfunction-associated steatohepatitis.