Prenatal exposures to PFASs and mercury were previously associated with elevated ALT levels and liver injury in children in the HELIX project.17,18 Previous cross-sectional studies16,50 reported positive associations between the plasma or serum concentration of PFASs, including perfluoro-octanoic acid, perfluoro-octane sulfonate, perfluorononanoic acid, and perfluorohexane sulfonate, and liver enzyme levels and/or nonalcoholic steatohepatitis in US children. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatohepatitis.