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We read with great interest the article of Ratziu and colleagues, who evaluated the potential of thrombospondin-2 (TSP2), insulin-like growth factor binding protein 7, CD163 and growth differentiation factor 15 (GDF15) as non-invasive biomarkers for identifying at-risk metabolic dysfunction associated steatohepatitis (MASH) and advanced liver fibrosis in a large multicentre European cohort.1 Plasma levels of these proteins were measured in patients with biopsy-proven MASH, and the authors tested the diagnostic performance for at-risk MASH and advanced fibrosis using area under the curve analysis. TSP2 had an AUROC of 0.812 for both advanced fibrosis and at-risk MASH, GDF15 had an AUROC of 0.738 and 732 for at-risk MASH and fibrosis, outperforming traditional screening measures such as FIB4 and VCTE. There remains a substantial unmet need for non-invasive biomarkers that can replace the invasive liver biopsy for the diagnosis of these conditions and this study clearly fills this gap.