These enzymatic indicators of inflammation and liver disease were associated with 517 SNPs, including variants in SERPINA1, APOE, GPAM, MARC1, and LEPR. The number of variants associated with any combination of ALT, ALP, and GGT is likely greater than the number found by studies that used imaging or histology to assess NAFLD because serum levels are not specific to NAFLD and are reflective of many processes in the body, including cardiovascular disease (87). This evidence concerns the gene LEPR and metabolic dysfunction-associated steatotic liver disease.