The aim of the present study was to assess the serum levels of 12 metabolic markers [adiponectin, leptin, ghrelin, TNFα, IL-6, PAI-1, cytokeratin-18 fragments, resistin, sIL-6R, sTNFR1, sTNFR2 and MMP-9] in patients with NAFLD and to investigate the potential association of these markers with the severity of fibrosis. Here, MMP9 is linked to metabolic dysfunction-associated steatotic liver disease.