Whole Genome Amplification and Genetic Analysis after Extraction of Proteins from Dried Blood Spots To the Editor: Programs to screen newborns for congenital disorders are based on analysis of dried blood spot samples

based NAFLD developed during 13 882.4 person-years of follow-up [incidence density (ID), 74.1 per 1000 person-years; 95%, CI 69.5–78.7], 700 incident cases of increased ALT, defined as serum ALT 35 U/L, developed during 13 822.4 person-years of follow-up (ID, 50.6 per 1000 personyears; 95% CI, 46.9–54.4). To minimize the effect of existing fatty infiltration on the baseline ALT, additional analyses were performed by excluding participants with incident NAFLD that occurred during the first 1 or 2 years of follow-up (Table 1). Although the magnitude of the association between ALT and NAFLD was slightly reduced, this analysis did not qualitatively change any of the observed associations (Table 1). Future research will shed light on the question of what underlies the relationship between ALT and an increased risk of NAFLD. We appreciate the opportunity to clarify our findings. The letter by Tagher and colleagues raises several important issues in the interpretation of our findings.