GPT and Insulin resistance: Epidemiological studies demonstrate that MetALD exhibits a prevalence of 5.8% and a unique clinical phenotype (65% of cases), characterized by a greater metabolic disease burden (88% obesity and 62% diabetes/insulin resistance) and more severe hepatic injury (32% elevated ALT/AST, 18.5% FIB-4 ≥ 1.3) compared to NAFLD alone [86].