GPT and metabolic dysfunction-associated steatotic liver disease: Serum alanine aminotransferase (ALT) is recommended as the best screening test for pediatric NAFLD according to the North American Society for Pediatric, Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Clinical Practice Guideline, with substantial limitations (e.g., less than 90% sensitivity, poor specificity) [14].