GPT and obesity due to melanocortin 4 receptor deficiency: A variety of metabolic disorders originating from obesity are concomitantly upregulated with ALT,66 specifically NAFLD is usually a prerequisite for unexplained mild ALT elevation,67 in this regard, assessing the aspartate aminotransferase (AST) value is of great importance because elevated AST/ALT ratio is prominently associated with a progressive and more severe condition, such as fibrotic NASH (Figure 2).