Participants with MetS were observed to have a significantly lower AST/ALT ratio, i.e., 0.83 (IQR: 0.63-1.09) in comparison to those without MetS, which is 0.94 (IQR: 0.71-1.34), with p-value = 0.008. We also observed significant differences in the distribution of age, sex, education levels, smoking status, diagnosed hypertension, obstructive sleep apnea, family history of hypertension, DTG-based ART duration, mid-upper arm circumference (MUAC), body mass index (BMI), aspartate aminotransferase (AST), and chloride, with p-value <0.05 between participants with and those without MetS (Table 1). Here, GPT is linked to obstructive sleep apnea syndrome.