Several further related markers [soluble TNF-alpha receptor-1 (sTNFR1), soluble TNF-alpha receptor-2 (sTNFR2), soluble IL-6 receptor (sIL-6R), ghrelin, plasminogen activator inhibitor-1 (PAI-1), cytokeratin-18 fragments, and matrix metalloproteinase-9 (MMP-9)] could play a significant role in NAFLD pathogenesis. This evidence concerns the gene MMP9 and metabolic dysfunction-associated steatotic liver disease.