Accordingly, the present study was aimed at evaluating (i) the discriminant accuracy of CK18 in identifying individuals suspected of having NAFLD (FLI ≥ 60) and (ii) within the subset of individuals with an FLI ≥ 60, the predictive ability of CK18 levels to predict high 10-year CVD risk according to Framingham Risk Score (FRS) and the Systematic COronary Risk Evaluation (SCORE)-2 algorithms. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatotic liver disease.