GPT and metabolic dysfunction-associated steatotic liver disease: In NAFLD FIB-4 has demonstrated similar results to the AST/ALT ratio where, using a cut-off of 1.3, an AUROC of 0.86, sensitivity 85%, specificity 65% and NPV of 95% were demonstrated for the diagnosis of advanced fibrosis.70 In a US-based comparison of several non-invasive markers of fibrosis in 541 NAFLD patients, FIB-4 had the highest AUROC of 0.802, with PPV and NPV of 80% and 90% respectively for diagnosis of advanced fibrosis.