Permutt et al. (38) showed that adult NAFLD patients with steatosis grade 1 might display characteristics of advanced liver disease (higher average AST/ALT ratio, GGT, and higher stage of fibrosis and hepatocellular ballooning), rather than those with grade 3 steatosis, highlighting that a low HFF does not necessarily indicate mild NAFLD. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.