Although several non-invasive markers for prediction of advanced fibrosis are available (aspartate aminotransferase-to-platelet ratio index - APRI; NAFLD fibrosis score; body mass index, ASL/ALT ratio and diabetes mellitus - BARD; FIB-4) [16,23,24,25], the present study suggests that patients with MO and more advanced age, high levels of ALT and TG should best be submitted to a full diagnostic evaluation such as liver biopsy to better assessment of hepatic damage. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.