In a 3-year prospective study with paired biopsies of NAFLD patients, it was demonstrated that in subjects with a stable or improved NAFLD activity score, the reduction in leptin levels was higher than in those with disease progression measured by an increase in NAFLD activity score; still, leptin variation could not predict the disease progression or fibrosis independently from BMI, which remained as a crucial factor associated with disease progression [190]. The gene discussed is LEP; the disease is metabolic dysfunction-associated steatotic liver disease.