In our study, subgroup analysis stratified by age showed that an elevated ALT/AST ratio was associated with a higher risk of NAFLD in children and adolescents younger than 20 years compared with participants in other age groups, with an AUC of 0.811, an optimal threshold of 0.865, a sensitivity of 0.767 and a specificity of 0.754. A previous community-based study by Lu et al. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.