GPT and metabolic dysfunction-associated steatotic liver disease: McPherson et al. [20] studied the impact of age on the performance of a range of NIT (NFS, FIB4, AST:ALT ratio, but not ELF) in detecting advanced fibrosis (compared with biopsy) in patients with Non-Alcoholic-Fatty-Liver-Disease (NAFLD), and found that all the tests performed less well in people over the age of 65 (with an increase in false positive rates in this age group).