The transmembrane heparan sulphate proteoglycan Syndecan-1 (CD138, SDC1), which is abundantly expressed in the liver, also exerts metabolic effects and is suggested to cause a strong impact on liver enzyme levels; previous studies have corroborated with this hypothesis given that NAFLD patients exhibit higher serum levels of syndecan-119. Here, SDC1 is linked to metabolic dysfunction-associated steatotic liver disease.