GPT and metabolic syndrome: In fully adjusted models (Fig. 2), CHD mortality was positively associated with the following groups: elevated biomarker ratio with MetS (elevated UACR: HR = 1.67, 1.05–2.67, and elevated AST-ALT: HR = 2.80, 1.62–4.86), and elevated BUN-CR without MetS (HR = 2.12, 1.12–4.04), compared to the referent group with neither elevated biomarker ratio nor MetS.