Overall, NAFLD patients with elevated ALT circulating levels have more frequent carotid atherosclerotic plaques, a higher risk of CHD [11,12,13], an increased prevalence of sub-clinical atherosclerosis, measured by carotid intima-media thickness (c-IMT), reduced arterial distensibility, and increased coronary artery calcium [14,15]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.