A meta-analysis involving 117,020 NAFLD patients over 5 years of follow-up showed an increased risk of T2DM (a combined relative risk of 1.97 for ALT, 1.58 for AST, 1.86 for GGTP, and 1.86 for ultrasonography, respectively) [48]. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.