GPT and metabolic dysfunction-associated steatohepatitis: Accordingly, Liu et al. proposed a composite biomarker that included miR-21, miR-192, miR-505, and alanine aminotransferase (ALT) to improve noninvasive NASH diagnosis 11, while Thietart et al. showed that a cluster of 12 miRNAs in serum EVs could distinguish patients with NASH from those with chronic hepatitis B and C or healthy controls 137.