It is clear that the thresholds for ALT when used as a screening tool for steatosis in children with MAFLD are far from being established, but according to the NASPGHAN guideline, a persistently elevated value of ALT >2x ULN is normal (52 IU/L in male children and 44 IU/L in girls) and might be used in order to select the patients that require further evaluation [80]. Here, GPT is linked to steatosis.