Given the likely under-diagnosis and thus under-estimate of NASH when relying only on ICD-9/10 coding, we evaluated a larger cohort of patients with available labs to assess ALT and concurrent metabolic co-morbidities after excluding those with HBV or HCV and excluding those with pregnancy or potential alcoholic liver disease, without relying on ICD-9/10 coding. Here, GPT is linked to metabolic dysfunction-associated steatohepatitis.