Nine out of the ten eligibly selected studies assessed the effect of MD on the major liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) [39,40,41,42,43,44,45,46,47], meaning that a total of 472 patients with NAFLD were assessed. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.