hi Shadowfall47 and welcomr,
glad youre making the necessary changes. losing weight and watching sugar and cholesterol should get you the desired results. Think of this as a lifestyle change. You should have periodic bloodwork to ensure your liver enzymes are normalizing, and your A1C and cholesterol are normal..
I also would take your lab results, to your primary care dr. You should be monitored for your high SMA. I would be very concerned if your liver enzymes remain high after a reasonable time.
NAFLD can not cause a SMA elevation..
liver biopsies are only performed, when liver damage is suspected, or needed for diagnostic purposes.
In the last decade, I have noticed that many people with chronic issues are low in vitamin D. This is also, something to bring up with your PCP.
let us know how your progressing, and best to you