In 271 French patients with type II diabetes the -493 G/T SNP was associated with increased liver enzymes and increased susceptibility to steatohepatitis, however this study provided only indirect evidence of a link between MTTP genotype and NASH, as liver biopsy specimens were not available and the authors adopted raised ALT as a surrogate for NASH [124]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatohepatitis.