Regarding T2DM, it has also been frequently reported that NAFLD predicts T2DM and that the studies based on liver biopsy reported higher prevalence rates of NAFLD versus laboratory-based or imaging-based studies [12,32,33] Finally, as mentioned above, our data may be less surprising considering that deranged ALT levels are a not reliable method with which to discriminate between NASH and NAFLD, particularly in diabetic patients[13]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatohepatitis.