In a human HepG2 liver epithelial cells model which has been used to simulate NAFLD in vitro [76], we observed that increasing MC-LR exposure did not lead to an increase in ALT or ALP gene expression, intracellular enzyme activity, or extracellular activity, despite a significant increase in MC-LR-induced cytotoxicity. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.