We may therefore postulate that, at least in type 2 diabetes subjects at high CV risk such as the CANVAS Program population, baseline ALT largely reflect lean body mass (cfr., the positive correlation with BMI, Additional file 4: Table S1), the relative scarcity of which (sarcopenia) is an obesity-independent risk factor for CVD [30]. The gene discussed is GPT; the disease is obesity due to melanocortin 4 receptor deficiency.