Liver biochemistries including AST, ALT, AST/ALT ratios, bilirubin, albumin and platelets were not different among the three groups, however alkaline phosphatase levels (U/I) were elevated (P<0.01) by nearly two-fold in both SS (98.7±9.1) and NASH (92.2±5.9) vs. the obese normal (53.2±8.8). Here, ALB is linked to metabolic dysfunction-associated steatohepatitis.