Similarly, DeBoer et al., in a retrospective analysis, reported that each standard deviation increase in the metabolic syndrome severity Z-score (MetS-Z) was associated with a greater likelihood of elevated ALT (OR = 1.58, 95% CI 1.44–1.72) and advanced fibrosis (OR = 1.96, 95% CI 1.77–2.18) [30]. Here, GPT is linked to metabolic syndrome.