Describe the role of alanine aminotransferase (ALT) in pyruvate metabolism.

Alanine aminotransferase (ALT) catalyzes the reversible reaction where pyruvate and glutamate are converted into alanine and α-ketoglutarate. The symptoms associated with ALT deficiency are generally mild, with an incidence rate of about 2.5 in 1,000 individuals.