A new score, NIS4TM, uses the biomarkers of miR-34a, alpha-2 macroglobulin, YKL40, and HbA1C to detect active steatohepatitis and advanced fibrosis (NAFLD activity score ≥4 and fibrosis ≥2). The gene discussed is A2M; the disease is metabolic dysfunction-associated steatotic liver disease.