Association of Liver Enzymes With Insulin Resistance and Cardiometabolic Risk in Adults With Obesity

Abstract

Elevated liver enzymes are frequently observed in adults with obesity and may reflect metabolic abnormalities associated with insulin resistance. This study evaluated the relationship between serum liver enzymes, insulin resistance, and cardiometabolic risk in adults with obesity. A cross-sectional observational study included 154 adults aged 30–65 years with BMI ≥30 kg/m². Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), fasting glucose, insulin, lipid profile, and blood pressure were assessed. Participants with higher ALT and GGT concentrations demonstrated greater insulin resistance, higher triglycerides, and increased waist circumference. ALT and GGT were positively correlated with HOMA-IR, while GGT showed the strongest association with the overall cardiometabolic risk profile. After adjustment for age, sex, BMI, and waist circumference, GGT remained independently associated with HOMA-IR. These findings suggest that liver enzyme concentrations, particularly GGT, may provide additional information regarding metabolic risk among adults with obesity.