In a prospective study enrolling 156 consecutive patients with biopsy-proven NAFLD and alanine aminotransferase (ALT) > 40 IU/L, 13.5% and 26.3% were diagnosed with sarcopenia with the SMI and sarcopenia index (SI; ASM-to-body mass index (BMI) ratio), respectively; in patients with hepatic fibrosis stage < 2, the SI and the skeletal muscle mass-to-body fat mass ratio were significantly higher than in patients with fibrosis stage ≥ 2 [50]. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.