GPT and acute-on-chronic liver failure: Jie et al. (2018) also demonstrated that a low PWR (<9.0) was linked to elevated ALT, total bilirubin, and MELD scores in patients with acute-on-chronic liver failure. Consistent with these findings, our study revealed that a low PWR was associated with more severe liver dysfunction, advanced fibrosis, and increased portal vein pressure in WD patients. Although gender has been associated with the clinical presentation of WD (Ferenci et al., 2019), our results show that both male and female patients with low PWR exhibit more pronounced liver dysfunction.