As one of the important routine medical examinations, liver function is often checked in various medical examinations, such as kindergarten admission, primary and secondary school students and college students’ admission, etc. Physical examinations are conducted. Among them, liver function is a mandatory test, and abnormal liver function often affects students’ normal schooling and studies, causing harm to families and individuals. Liver function tests include many components, such as transaminases, bilirubin, total protein and albumin, etc. Transaminases are considered to be sensitive indicators of liver cell damage. But does an elevated transaminase necessarily mean liver damage? It is common to see patients who undergo liver function screening for routine physical examinations or other reasons and find that transaminases are consistently elevated, while pathogenic tests for liver diseases such as hepatitis A, B, C, D, E and other viral antibodies such as cytomegalovirus antibodies and EBV antibodies are negative. The liver was normal on abdominal ultrasound. In some cases, liver biopsy was performed and no abnormalities were found on pathological examination. Some patients had been transferred to several hospitals and spent a lot of money on liver-protective treatment according to hepatitis, but the transaminases still did not drop. Later, the patient’s muscle enzymes were checked and found to be even more significantly elevated. Electromyography was performed on the patient and suggested myogenic damage. Muscle biopsy confirmed muscle disease such as myotonic dystrophy and dermatomyositis. Transaminase is an enzyme that transfers the amino group of the a-amino acid to the keto group position of the a-keto acid, and there are several types. The commonly used ones are glutamate oxaloacetate transaminase (GOT or AST) and glutamate pyruvate transaminase (GPT or ALT). Some studies have shown that AST lacks organ specificity and is present in large amounts in liver, kidney, heart, and muscle tissue, whereas ALT is relatively liver specific. Therefore, in addition to the liver, there are other sources of transaminases, such as muscle, heart, kidney, and red blood cells. Because transaminases are present in large amounts in muscle tissue, elevated transaminases can be seen in muscle disease and can be elevated in the early stages of muscle disease. There are several muscle diseases with persistent transaminase elevations as the main manifestation, the most common of which is myotonic dystrophy, followed by inflammatory muscle disease. If a clinical patient does not have any symptoms of liver function abnormalities such as jaundice, poor appetite, aversion to grease, etc., but only has abnormally elevated transaminases, while other liver function indicators such as bilirubin and albumin are normal, muscle enzyme tests should be routinely performed to exclude muscle disease, thus avoiding numerous liver pathogenic tests and ineffective treatment and reducing the medical burden on the patient.