The Enhanced Liver Fibrosis (ELF) panel, consisting of procollagen III amino-terminal peptide (PIIINP), hyaluronic acid and tissue inhibitor of metalloproteinases 1 (TIMP1), has been validated in cross-sectional studies against liver biopsy and used alongside with liver biopsy in a number of phase 2 and 3 NASH trials [79]. Here, TIMP1 is linked to metabolic dysfunction-associated steatohepatitis.