GPT and fatty liver disease: On the other hand ALT > 45 IU/l was considered abnormal in boys and > 34 IU/l in girls; only 3 patients had increased level (4.1% of the total number of cases and they represented only 6.5% of the NAFLD cases) this agrees with the opinion that normal liver enzymes do not exclude fatty liver [39], and further suggests that serum liver enzymes are good indicators for NAFLD diagnosis, however, ‘‘normal’’ standard levels used for exclusion of NAFLD are needed to be reviewed.