That said, while the Treatment of NAFLD in Children (TONIC) trial, in which a large non-diabetic paediatric cohort was used to compare metformin with Vitamin E therapy, found metformin to be no more effective than a placebo in achieving a sustained decrease in ALT levels, it did show significant improvement in hepatocyte ballooning [164]. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.