NORMAL LIVER ENZYMES LINKED TO DIABETES? I remember early on in practice not recognizing this for what it was. I had a few patients with mildly elevated liver enzymes (AST, ALT). They would just comment that they’ve always been elevated. Usually their doctor had run a barrage of liver tests looking for viral hepatitis. But, with time, I’ve come to understand that prediabetes is very damaging to the liver, just like every other organ that is affected by this condition. I’ve even come to recognize that high normal values, when combined with other factors (abdominal obesity, elevated cholesterol / triglyerides, elevated uric acid, etc..) are a strong sign of prediabetes. Something else to consider here…we view AST and ALT as “liver function” tests. What we’re really looking at here are cells that are dying off and spilling their enzymes into the blood stream. Doesn’t really sound like a test of “function” but rather a test of “dead…”