Although NAFLD is often diagnosed after the finding of mildly abnormal LFTs, more than two thirds of patients have normal aminotransferase levels at any given time37 and the entire histological spectrum of NAFLD can be observed in patients with normal alanine aminotransferase (ALT) values.38, 39 ALT is usually greater than aspartate aminotransferase (AST), and rarely more than three times the upper limit of normal. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.