After stratification, four groups (female, early puberty, male and early puberty, and female and early puberty) showed a higher OR, and the female group showed the maximal OR of 1.104 (95% CI, 1.061–1.148), which means that in the early puberty age stage, ALT might be a necessary risk factor for NAFLD, especially in female children. This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.