The aspartate aminotransferase to alanine aminotransferase (AST:ALT) ratio, BARD score and non-alcoholic fatty liver disease (NAFLD) fibrosis scores all have a high negative predictive value (>92%) for advanced fibrosis and as such can be used as tools to identify those most at risk of disease.8 Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.