Robbins JM, et al. - In this combination of cross-sectional and longitudinal analyses involving 439 patients, researchers explored the connection between a novel circulating biomarker of hepatic fat, dimethylguanidino valeric acid (DMGV), and metabolic health traits before and after 20 weeks of endurance exercise training. Findings revealed that baseline levels of DMGV were positively linked to body fat percentage, abdominal visceral fat, very low-density lipoprotein cholesterol, and triglycerides, and inversely linked to insulin sensitivity, low-density lipoprotein cholesterol, high-density lipoprotein size, and high-density lipoprotein cholesterol. The authors concluded that DMGV is an early indicator of cardiometabolic dysfunction associated with lower lipid and insulin sensitivity improvements after exercise training. DMGV levels may identify people at a young age who require additional therapies to enhance their metabolic health beyond guideline-directed exercise.