Previous studies have shown that CK18 is a potent tool for the noninvasive diagnosis of NASH,22,23 and the specificity of cCK18 for NASH prediction is higher than that of M2BPGi, FIB4 index, APRI, and other diagnostic indicators.24 Thus, we examined the serum CK-18 levels in both groups, and our results were consistent with those of published studies, manifesting as a significantly increased level of serum CK18 in the NASH group. This evidence concerns the gene CCK and metabolic dysfunction-associated steatohepatitis.