Mild elevation af ALT is acommon clinical problem of varius causes .Except fo those that can be attributed to viral hepatits ,alcohol or other chemical toxin exposure,most of these cases are of non specific causes or fatty liver related .
Also many cause of mildly elevated serum ALT levels should be excluded before decision of u explained elevation is taken.
Agrowing number of studies have suggested that elevation of ALT in absence of specific liver disease or DM was associated with insulin resistance.
Both ethinicity and gender seem to play roles in the prevelance of mild elevation of ALT .Compared to women ,men were more prone to have unexplained elevation of ALT although they had approximately equal prevalence of T2DM.
In this study, obesity(BMI30) and hypercholesterolemia (total cholesterol$200 mg/ dl) were identified to be significantly associated with abnormal ALT especially in younger males (age,35 years). It has been demonstrated that augmented ALT activities can be predictor of development of IR,MD, Cardiovascular disease and mrtabolic syndrome.
The longitudinal increment of individuals' ALT activity over time increased the incidence risk of metabolic syndrome and the effects generated by longitudinal increments of ALT on MetS was higher than that generated by baseline ALT.
Studies are needed to better define the risks, particularly better diagnostic criteria allowing differentiation of NAFLD, and most importantly NASH. This serious and potentially preventable public health issue has major implications for health and wellbeing in this health disparity population. Failing to intervene with preventive measures will have considerable impact on the community and the economy and will impact costs and capacity within the already stretched health care system.