I've had 2 recent tests showing my actin (smooth muscle) antibody at 60. The liver biopsy indicated a fatty liver- no autoimmune liver. What could it b?

Fatty liver. Like all medical tests, the anti-smooth muscle test can have false positives as it is in you. The liver biopsy gave your dx: fatty liver....Which is a type of hepatitis that is common and caused by fat deposition in your liver. This condition is often associated with obesity, high triglycerides, and diabetes. The key to treat this is weight loss and exercise.
Fatty liver. Careful not to overinterpret lab tests, such as autoantibodies such as anti-smooth muscle antibodies. Positivity does not equal diagnosis: this appears to be the case with the biopsy results.

Related Questions

Since my liver biopsy showed fatty liver, why is my actin antibody 62 then 54?

Just an association. Assuming your actin antibody is actually a f-actin smooth muscle antibody (asma or sma) this is checked in patients as a chronic liver disease workup. There is an overlap and association with the asma and fatty liver disease seen in up to 20% of those with fatty liver disease. You might even have a positive ANA also. Nothing to be worried about. You can ignore it (if you only have fatty liver)!