Liver biopsy is required to establish a definitive diagnosis of NASH; however, given its invasive nature, only patients at high risk for NASH or advanced fibrosis, such as patients with an AST/ALT ratio greater than 1, thrombocytopenia, hypoalbuminemia, or symptoms and signs of portal hypertension should undergo the procedure [2]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatohepatitis.