Moreover, elevated alanine aminotransferase (ALT) levels and markers of liver inflammation, are independently associated with an increased HCC risk (hazard ratio (HR) 6.80, 95% CI: 3.00–15.42; p < 0.001) in patients with non-cirrhotic NAFLD, according to the role of a proliferative environment and inflammation on tumorigenesis [96]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.