A systematic review with meta-analysis [16] including six clinical trials showed that silymarin reduced serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in NAFLD patients, but the studies appraised in that meta-analysis had a high degree of heterogeneity and low methodological quality. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.