However, the other three robust pleiotropy methods yielded different results from the main MR analysis; no causal association was found between ALT and diabetic retinopathy by using MR-Egger (1.01 [0.74-1.39], P = 0.931), the weighted median (1.13 [0.87-1.47], P = 0.370) and the mode-based estimator (1.01 [0.72-1.41], P = 0.967) (Figure 4). The gene discussed is GPT; the disease is diabetic retinopathy.