Elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels have been associated with metabolic syndrome (MS), insulin resistance (IR), diabetes, endothelial dysfunction, coronary atherosclerosis, and cardiovascular (CVS) events, in addition to diseases of the liver [ 1– 4]. Studies have also shown that elevated AST/ ALT ratio in women could predict severity of coronary atherosclerosis [ 3]. Hence, in recent years, there has been a renewed interest in using ALT and AST as biomarkers for assessment of CVS risk. Serum AST levels were first described as a biomarker for myocardial necrosis in the 1950s [ 5] but were replaced by other more sensitive and specific biomarkers like creatinine kinase myocardial b fraction (CKMB) and troponins.