Even though CK-18 is unavailable for usual practice and more feasible for trials [18,29], recent studies showed a promising result regarding NAFLD diagnosis, especially in combination with FIB-4 (fibrosis 4 index) test and MACK-3 test (a new blood test consisting of Homeostatic Model Assessment-Index Insulin Resistance (HOMA-IR), aspartate aminotransferase (AST), and CK18 levels) [40]. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatotic liver disease.