The enhanced liver fibrosis (ELFTM) test is based on three extracellular matrix proteins including hyaluronic acid (HA), procollagen-3 N-terminal peptide (P3NP), and tissue inhibitor of metalloproteinase-1 (TIMP-1), and has been studied in adult and pediatric patient populations with NAFLD [68,69,70,71]. The gene discussed is TIMP1; the disease is Hepatic fibrosis.