Thus, the current work aimed to clarify the role of DNA methylated genes, i.e., sphingomyelin phosphodiesterase 3, Smpd3 in liver tissue and adipose tissue of NASH and mild fibrosis, for identifying biomarkers for differentiating different stages of NAFLD and providing precision medicine approaches to NAFLD diagnosis and management. This evidence concerns the gene SMPD3 and metabolic dysfunction-associated steatohepatitis.