In the assisted reproduction group, GDM did not mediate the indirect effect of ALT levels on LGA both before adjustment (β = 0.0004, 95% CI: -0.0021–0.0016) and after adjustment (Model 2: β = 0.0007, 95% CI: -0.0009–0.0038; Model 3: β = 0.0007, 95% CI: -0.0019–0.01287) (Table 6). The gene discussed is GPT; the disease is gestational diabetes.