The second aim was to compare NIS4®, NIS2+TM, FIB-4, NAFLD fibrosis score (NFS), ELFTM, and ALT in a cohort of patients ≥65 years of age in order to determine which test had the highest overall performance for detecting at-risk NASH in elderly patients who would benefit from intensive lifestyle or therapeutic interventions. This evidence concerns the gene GPT and metabolic dysfunction-associated steatohepatitis.