A new study published in Hormone Research in Paediatrics investigated the potential role of elevated liver enzyme levels in the predisposition for metabolic syndrome (MetS) in children. In this cross-sectional study, 77 obese non-diabetic children were enrolled from the University of Bonn, Germany. The results revealed a high prevalence of hypertension (51%), dyslipidemia (52%), elevated liver enzyme levels (51%), and hyperglycemia (24%) among these children. A considerable overlap was observed between the presence of different MetS risk factors in individuals; 40% of the participants had ≥3 of a maximum of 5 MetS risk factors. While elevated liver enzyme levels were significantly associated with reduced insulin sensitivity, as the oral glucose tolerance test (OGTT)-insulin response was markedly higher in participants with elevated transaminases. Moreover, this association was independent of hyperglycemia and dyslipidemia. Hence, it was concluded that liver enzyme levels are related to insulin sensitivity in obese children and could therefore be an indirect indicator for MetS. Thus, testing for disturbed glucose metabolism was recommended for obese children with elevated liver enzymes.