GPT and obesity due to melanocortin 4 receptor deficiency: Liver enzymes—including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP)—are frequently elevated in pre-diabetic and diabetic individuals and have been associated with obesity, visceral adiposity, dyslipidemia, increased diabetes risk, and metabolic dysfunction–associated steatosis liver disease (MASLD) [45,46,47,48,49,50].