Liver biopsies of 330 patients with type-2 DM with sustained ALT levels >20 and >30 U/L in females and males, respectively, showed that metabolic dysfunction-associated steatohepatitis (MASH) and cirrhosis are present in 58% and 10% of cases, respectively, indicating that even cases with low ALT levels have fibrosis progression [12]. The gene discussed is GPT; the disease is fibrosis.