In a study by Feldstein et al., with a cohort consisting of 139 patients with biopsy-proven NAFLD from eight centers across the United States, CK-18 fragments ranged from 68 to 3000 U/L and were markedly increased in patients with NASH as compared to levels in those without NAFL (median (Q1, Q3): 335 (196, 511) vs 194 (151, 270) U/L) [27]. Here, KRT18 is linked to metabolic dysfunction-associated steatotic liver disease.