ALT is a crucial biomarker for liver function, with elevated serum ALT levels indicative of hepatic impairment.[33] It is worth noting that research conducted in the past 10 years has shown that the skeletal joint system is not just a simple load-bearing structure, but also an important endocrine organ that secretes cytokines that govern many organs throughout the body, including the liver.[34] A prospective cohort study involving 2055 community participants revealed that women with lower serum osteocalcin levels are at an increased risk of developing nonalcoholic fatty liver disease. This evidence concerns the gene BGLAP and metabolic dysfunction-associated steatotic liver disease.