Furthermore, transferring the gut microbiota from patients with NASH to germ-free mice while feeding the animals a high-fat diet (HFD) resulted in a substantial increase in ALT, AST, and inflammatory markers, along with hepatic steatosis and liver inflammation, whereas the germ-free mice fed HFD had only lipid accumulation and mild liver inflammation (Hoyles et al., 2018). Here, GPT is linked to fatty liver disease.