HP and steatosis: While the correlation between zonulin levels and SteatoTest score was modest (ρ = 0.162, p = 0.287), the noticeably higher prevalence of moderate-to-severe steatosis in this subgroup (78.6% vs. 55.3%) raises the possibility that microbial translocation through a disrupted gut barrier may contribute to systemic inflammatory responses and promote fat deposition within the liver [19,20,21].