Although reference values for ALT have frequently been questioned by specialists [24] and standardized values for the Brazilian population are not available, patients with T1D and metabolic syndrome have higher ALT levels that might be related to hepatic lesion, especially if they are associated with non-Caucasian ethnicity, male gender, elevated triglycerides (>129.5 mg/dL), uric acid, and HbA1c. Here, GPT is linked to metabolic syndrome.