AST (Aspartate Transaminase)

An enzyme found in your liver as well as your heart and muscles. On its own, AST is less specific, but compared with ALT it tells a story. In fatty liver disease, ALT is usually higher. When AST climbs to twice ALT or more, it often points to alcohol-related liver damage or more advanced scarring.

ALT (Alanine Aminotransferase)

The most liver-specific enzyme on this panel. ALT lives inside your liver cells and leaks into your blood when those cells are inflamed or damaged. It's usually the first marker to rise in fatty liver disease, which affects about 1 in 3 American adults, most of whom don't know it.

GGT (Gamma Glutamyl Transferase)

An enzyme on the surface of your liver and bile duct cells, and one of the most sensitive markers of alcohol's impact on your liver. GGT rises with regular drinking and usually falls within weeks of cutting back. It also flags bile flow problems and helps your liver recycle glutathione, its main antioxidant.

Average Blood Sugars

Your average blood sugar over the last 2 to 3 months. Your liver stores and releases sugar, and when you're insulin resistant, it converts excess sugar into fat that builds up inside liver cells. Most people with type 2 diabetes have fatty liver, and fatty liver makes blood sugar harder to control.

Inflammation

A protein made by your liver in response to inflammation anywhere in your body. Chronic inflammation is what pushes simple fatty liver toward MASH, a more serious form that causes liver scarring (fibrosis). Raised hs-CRP alongside high liver enzymes is a signal worth taking seriously.

Visceral Fat

The deep belly fat stored around your organs. Visceral fat drains directly to your liver, flooding it with fatty acids and inflammatory chemicals. It's one of the strongest predictors of fatty liver disease, even in people who aren't overweight.