Even after multivariate adjustments for factors previously found in other studies to be associated with differing ALT levels (sex [2], [4], [7], [8], [11]; alcohol use [7]; components of the metabolic syndrome [4]–[11]: BMI, waist-hip ratio, diabetes, fasting glucose, total cholesterol to HDL ratio, triglycerides), for surrogate markers of adiposity (leptin [4], IL-6 [27], [28], adiponectin [29], [30], ghrelin [31], [32]), and for other markers of liver function (bilirubin, GGT, albumin), the association of rising age with decreasing ALT remained significant (p<0.0001, Table 2). This evidence concerns the gene LEP and metabolic syndrome.