Using this approach, we found that, compared to patients with simple steatosis, patients with NASH experienced a significantly greater adjusted decrease in ALT (β coefficient − 12 iU/l [− 22 to − 1.83], p = 0.021), insulinemia (β coefficient − 10.76 mIU/l [− 17.01 to − 4.51], p = 0.001), and Homa-IR (β coefficient − 5.01 [− 7.06 to − 2.95], p < 0.001). This evidence concerns the gene GPT and metabolic dysfunction-associated steatohepatitis.