Koutny F, Stein R, Kiess W, et al. - Researchers sought to determine if increased concentrations of alanine aminotransferase (ALT) as a proxy for nonalcoholic fatty liver disease (NAFLD) could predict future dysglycemia among children. They conducted survival analysis up to 11 years of follow-up on longitudinal data of 510 children who were overweight and obese and were selected from the Leipzig Childhood Cohort. A more than 2-fold elevated risk for future dysglycemia, independent of age, gender and body mass index standard deviation score, was observed in children with overweight/obesity and elevated ALT values. Findings showed that glycemic deterioration was early predicted by increased transaminases. Thus, further addressing NAFLD as a risk factor and treatment target for the early prophylaxis of type 2 diabetes, is recommended.