Therefore, ALT/AST is not only a marker of liver injury, but also a simple predictor of GDsusceptibility in patients with fatty liver (36) association of direct bilirubin (DBil) and indirect bilirubin (IBil) with MAFLD and the development of gallstones may be due to the fact that these two markers are not only signaling for cholestasis and hepatocellular damage, but may also influence cholesterol crystallization through two pathways: oxidative-antioxidant homeostasis and lipid metabolism (37, 38). Here, GPT is linked to gallstones.