Nevertheless, these findings are echoed by a systematic review and meta-analysis of patients with DIOS and non-alcoholic fatty liver disease, which found no effect of iron depletion on HOMA-IR, insulin level, alanine aminotransferase (ALT), aspartate aminotransferase (AST) or liver fibrosis, even in those with high ferritin [107]. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.