In the crude model, there was a positive correlation of the ALT/AST ratio with NAFLD risk, and the HRs corresponding to the quintile of the ALT/AST ratio were 1, 2.00 (1.62, 2.47), 3.01 (2.47, 3.67), 4.82 (3.99, 5.81) and 7.81 (6.52, 9.36) (P for trend< 0.001) for NAFLD risk. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.