The summarized proportion of NAFLD patients with normal ALT value in MRI diagnostic group was 0.43 (95%CI: 0.39–0.38), which higher than in the Histology diagnostic group 0.22 (95%CI: 0.17–0.28, I2 = 85.0%) and Ultrasonography diagnostic group 0.26 (95%CI: 0.20–0.34, I2 = 83.0%). Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.