GPT and metabolic dysfunction-associated steatotic liver disease: The concomitant increase of in serum alanine aminotransferase (ALT) levels suggests that iron and ferritin be released from damaged hepatocytes as a result of hepatic necro-inflammation.14 In addition, increased iron has been shown to enhance HCV replication in vitro.15 Furthermore, hyperferritinemia and increased iron stores have been associated with the severity of liver damage in non-alcoholic fatty liver diseases (NAFLD), and iron depletion reduced insulin resistance and liver enzymes.