GPT and metabolic dysfunction-associated steatotic liver disease: Among the included studies, 5, 5, 4, and 3 studies compared the serum ALT, AST, ALP, and GGT levels between ANA-positive and ANA-negative NAFLD patients with a histological diagnosis, respectively, whereas the results of meta-analysis revealed that no significant differences in the four hepatic enzymes were found, with total random-effects MDs of 2.98 (95% CI − 14.37 to 20.33), 3.62 (95% CI − 7.13 to 14.38), 0.02 (95% CI − 10.68 to 10.73), and − 5.73 (95% CI − 16.01 to 4.54) U/L, respectively.