Interestingly, this pattern of diet ameliorates insulin resistance even in the absence of weight loss, acting on a pathophysiological level [41], and improves blood levels of transaminases (alanine aminotransferase, ALT) as surrogate markers of hepatic necroinflammatory activity, but also liver stiffness at elastography after 6 months of treatment [47]. Here, GPT is linked to Insulin resistance.