A combination of five variables with the largest AUC, including ALT, AST, ALP, AST:ALT ratio, and ALP:TBil ratio, had the best cut-off point of ≥ 1.5 for ALF-WD, which had 100% sensitivity, 91.3% specificity, 11.5 positive likelihood ratio, 0.00 negative likelihood ratio, and an AUC of 0.9937 (p < 0.0001). Here, GPT is linked to Wilson disease.