The summarized proportion of NAFLD patients with normal ALT value in more than 300 size group was 0.27 (95%CI: 0.23–0.33, I2 = 97.0%), which higher than in less than 300 size group 0.22 (95%CI: 0.14–0.31, I2 = 46.0%). The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.