TIMP1 and metabolic dysfunction-associated steatotic liver disease: The ELF score uses an algorithm combining HA, TIMP1, and PIIINP to create a score that has been found to be highly sensitive and specific for determining stage of liver fibrosis in adults and pediatric patients with NAFLD, and is under investigation for cystic fibrosis liver disease and biliary atresia [19,25,44–47].