GPT and metabolic dysfunction-associated steatotic liver disease: Currently, there is no serologic biomarker to confirm the diagnosis of NAFLD, but ALT elevation (above normal laboratory reference ranges) is the most common laboratory manifestation of NAFLD, and ALT elevation unexplained by viral hepatitis, ethanol, or iron overload has been used as a surrogate biomarker for NAFLD in the National Health and Nutrition Examination Survey (NHANES) (Clark 2006).