Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of triglycerides in the liver in absence of excessive alcohol consumption.[5] NAFLD is closely associated with cardiovascular disease and even all-cause mortality.[6,7] The gold standard for the diagnosis of NAFLD is liver biopsy.[8] Because of its limitations and invasiveness it is not performed in clinical practice and surrogate markers, mainly liver enzymes like the aspartat aminotransferase (AST)/alanin aminotransferase (ALT) (De-Ritis) ratio (AAR) are used for the diagnosis of this common disease.[5]. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.