Previous studies have already illustrated that nonalcoholic fatty liver disease is associated with the progression of gallstone formation.[22,23] Furthermore, hepatitis C virus infection and cirrhosis are associated with the development of gallstones.[24] An increased serum ALT level upon hospital admission could predict the risk of gallstone disease due to transient ampullary obstruction causing a rapid increase in bile duct pressure and consequent liver cell damage. This evidence concerns the gene GPT and hepatitis C virus infection.