Finally, in a recent cross-sectional study involving 4,648 health check-up subjects [7], Chung et al. found that the prevalence of ultrasound-diagnosed NAFLD and abnormal ALT levels increased steadily with increasing grades of hypothyroidism (for NAFLD, subclinical: 29.9% and overt: 36.3%; for abnormal ALT, 20.1% and 25.9%, P < 0.001, resp). Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.