Hormonal

Elevated serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are not merely biomarkers of liver injury but reflect active hepatic transamination and deregulated amino acid metabolism (specifically the glutamine-glutamate cycle) that contributes to the pathogenesis of metabolic syndrome and insulin resistance.

If your ALT or AST levels are elevated, even within the 'normal' lab range, do not dismiss them as normal. This paper suggests these enzymes are active participants in metabolic syndrome, driving insulin resistance through amino acid metabolism. You should view elevated liver enzymes as a warning sign of metabolic dysregulation and prioritize interventions that improve insulin sensitivity and liver health, such as reducing refined carbohydrate intake and managing body weight, rather than ignoring them because you feel fine.