When women were arranged by pregravid obesity and ALT levels (low, < 17 U/L, or high, ≥ 17 U/L), women with pregravid obesity and high ALT levels also showed significantly raised ORs for GDM − IT (OR 1.747, 95% CI 1.021–2.992), and GDM + IT (OR 3.193, 95% CI 1.381–7.382), as against women without pregravid obesity and with low ALT levels. Here, GPT is linked to obesity due to melanocortin 4 receptor deficiency.