Research

Hormonal

Elevated alanine aminotransferase (ALT) levels in nondiabetic individuals are associated with decreased hepatic insulin sensitivity and predict the future development of type 2 diabetes, independent of obesity and whole-body insulin resistance.

If you have elevated ALT, even within the standard 'normal' lab range, it may signal reduced liver insulin sensitivity and a higher risk of developing type 2 diabetes. This is particularly relevant if you have high body fat. Focus on improving hepatic insulin sensitivity through weight management and metabolic health, as ALT serves as an early warning marker independent of whole-body insulin resistance.

GoodSupportsHIGH confidence
Higher ALT concentrations were cross-sectionally associated with obesity and whole-body and hepatic insulin resistance and prospectively associated with a decline in hepatic insulin sensitivity and the development of type 2 diabetes.
Barbora Vozarova et al. · Diabetes · 2002

Why this rating

Prospective longitudinal study with rigorous metabolic clamping (gold standard for insulin sensitivity) and adjustment for confounders.

Source

High Alanine Aminotransferase Is Associated With Decreased Hepatic Insulin Sensitivity and Predicts the Development of Type 2 Diabetes

Barbora Vozarova et al. · Diabetes · 2002

DOI 10.2337/diabetes.51.6.1889

cohort · n=451Cited 716×
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DOI resolved against Crossref · corpus check 2026-06-10

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