GPT and metabolic disease: These findings are in line with the findings of prior studies.42,43 For instance, Shih et al state that individuals with hyperuricemia are more likely to have heightened liver enzymes (AST or ALT), even after adjusting for confounders.42 It has been reported non-alcoholic fatty liver disease (NAFLD) is closely linked with obesity, diabetes mellitus, and MetS.44-46 Therefore, NAFLD is believed to be a hepatic outcome of metabolic diseases.47 It turns out that SUA levels increase in most NAFLD patients,48 indicating that it can be an independent predisposing factor for NAFLD.49