After adjusting for potential confounders, a high AST/ALT ratio was identified as an independent risk factor for pleural effusion (OR = 2.039; 95% CI: 1.141–3.645; p = 0.013), acute heart failure (OR = 4.695; 95% CI: 1.207–18.260; p = 0.026), acute kidney failure (OR = 5.474; 95% CI: 2.181–13.738; p < 0.001), SIRS (OR = 1.966; 95% CI: 1.070–3.612; p = 0.029), and vasopressor use (OR = 7.099; 95% CI: 1.467–34.345; p = 0.015) (Table 7). The gene discussed is GPT; the disease is Pleural effusion.