Metformin, an oral insulin-sensitising agent, lowers hepatic glucose production and promotes glucose uptake in the periphery and, when given in 500 mg doses twice daily for 24 weeks, has been shown to reduce hepatic steatosis on magnetic resonance spectroscopy and ALT levels in non-diabetic children with biopsy-proven NASH [163]. Here, GPT is linked to metabolic dysfunction-associated steatohepatitis.