The main aim of the present study was to ask if differential DNA methylation at the PPARγ promoter can be detected within the pool of cell-free DNA of human plasma and if so then do levels of methylation at this loci correlate with fibrosis stage in NASH. While there is unquestionably a role for gene polymorphisms in the progression of NASH to fibrosis there is also strong evidence for the involvement of lifestyle factors (age, diet, exercise, other comorbidities and so on).