Early recognition is crucial for timely enzyme replacement therapy.<h4>Objectives</h4>To screen for LAL-D in subjects with dyslipidemias and/or liver disease at an outpatient lipid clinic.<h4>Methods</h4>We retrospectively assessed records from 2,018 adults and children using a screening algorithm including ALT/AST elevation >1.5 x upper limit of normality, LDL-C>160 mg/dL, HDL-C<40 (males) or <50 mg/dL (females) in adults, and LDL-C>130 mg/dL, HDL-C<45 mg/dL, in children. This evidence concerns the gene GPT and metabolic syndrome.