The time has come to look for metabolic-dysfunction associated fatty liver disease in adult patients with type 1 gaucher disease.

MAFLD encompasses a broad spectrum of histological lesions spanning steatosis, ballooning and inflammation with/without fibrosis. We agree that steatosis with necro-inflammation, featuring steatohepatitis, more likely progresses to clinically significant liver fibrosis than histological "simple" steatosis. However, according to current guidelines, the screening approach for MAFLD in at-risk populations and the diagnostic work-up in patients with suspected MAFLD should start with non-invasive evaluation of steatosis, followed by non-invasive assessment of fibrosis.