This is in contrast to the 16.4% frequency of elevated ALT in Type-2 diabetic patients with NAFLD in a study conducted by Butt et al.8 This difference in the proportion of raised ALT between this study and our study could be due to that patients included in our study had a relatively longer duration of T2DM, had greater mean BMI, higher mean waist circumference and higher mean HbA1c. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.