GPT and obesity due to melanocortin 4 receptor deficiency: It has been recommended that children at high risk for NAFLD (including obesity) be screened for NAFLD [9], and in 2017, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) published a guideline recommending alanine transaminase (ALT) to screen for NAFLD in children aged 9 years and older with a body mass index (BMI) ≥95th percentile [10].