In studies from the United States confirming a positive relationship between ALT and BMI, the strongest association was found for waist-to-hip ratio [15] and trunk fat using dual-energy X-ray absorptiometry (DEXA) to measure body composition, indicating central adiposity to be an important obesity-related determinant of elevated ALT [16]. Here, GPT is linked to obesity due to melanocortin 4 receptor deficiency.