In the present study, we corroborated the previously reported, strong relationship between NAFLD and sE‐selectin.7, 8 In addition, using large cohorts we are able to adjust for potential confounding factors, such as smoking, low‐grade inflammation, plasma lipids, type 2 diabetes and cardiovascular disease, which have all been associated with systemic endothelial dysfunction.4, 5, 37, 38, 39 We observed that plasma ALT levels were associated with sE‐selectin, independent of these potential confounders. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.