The study concluded that although the diagnostic efficacy of CHI3L1 alone was not significant, the NIS4 for high-risk NASH outperformed other blood-based diagnostic scores such as the FIB-4, the NAFLD fibrosis score(NFS), and APRI (NIS4, AUC = 0.80; CHI3L1, AUC = 0.69; APRI, AUC = 0.74; FIB-4, AUC = 0.70; NFS AUC = 0.66). Here, CHI3L1 is linked to metabolic dysfunction-associated steatohepatitis.