The objectives of this study were therefore to determine the proportion of patients with MAFLD and normal ALT levels who have histological evidence of NASH and the proportion of patients with MAFLD and elevated ALT levels who have NASH; to assess the MAFLD activity score in patients with MAFLD and NASH; and to relate the histological findings to the ultrasound grading of fatty liver disease. Here, GPT is linked to fatty liver disease.