During the five-year follow-up period, 2147 individuals (17.7%) developed new-onset NAFLD, and the incidence of NAFLD increased gradually by increasing quintile of the ALT/AST ratio (Q1: 5.7% vs Q2: 9.6% vs Q3: 13.9% vs Q4: 23.09% vs Q5: 35.78%). The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.