This technique was verified as a capable non-invasive tool in NAFLD/NASH diagnosis.6 Swiderska M and his colleges found altered levels of CK18 depending upon the severity of disease inspite of having normal serum ALT.10 Incontrast to this, our study found positive association of CK18 with serum ALT. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatohepatitis.