By contrast, there were no associations for the following groups: those with an elevated biomarker ratio without MetS (elevated BUN-CR: HR = 1.05, 0.79–1.39; elevated GGT-ALP: HR = 1.24, 0.92–1.67), MetS without elevated biomarker ratio (normoalbuminuria: HR = 1.05, 0.89–1.24; BUN-CR: HR = 1.10, 0.93–1.31; GGT-ALP: HR = 1.12, 0.96–1.32; AST-ALT: HR = 1.17, 1.00–1.38), and MetS with elevated biomarker ratio (elevated BUN-CR: HR = 1.26, 0.96–1.64; elevated GGT-ALP: HR = 1.26, 0.95–1.67), compared to referent. The gene discussed is GPT; the disease is metabolic syndrome.