Huang et al. showed that a combination of patient risk factors, such as NASH with comorbid diabetes and obesity, as well as longitudinal assessments of fibrosis scores, such as persistently elevated Fib-4 scores or temporally increasing Fib-4 scores, was an effective approach to identify those patients as at the highest risk of developing HCC [35]. Here, FBL is linked to obesity due to melanocortin 4 receptor deficiency.