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. 2014 Apr 7;14(4):e14112.
doi: 10.5812/hepatmon.14112. eCollection 2014 Apr.

Alanine aminotransferase elevation in obese infants and children: a marker of early onset non alcoholic Fatty liver disease

Guido Engelmann  1 , Georg Friedrich Hoffmann  2 , Juergen Grulich-Henn  2 , Ulrike Teufel  2
Affiliations

Alanine aminotransferase elevation in obese infants and children: a marker of early onset non alcoholic Fatty liver disease

Guido Engelmann et al. Hepat Mon. .

Abstract

Background: Elevated aminotransferases serve as surrogate markers of non-alcoholic fatty liver disease, a feature commonly associated with the metabolic syndrome. Studies on the prevalence of fatty liver disease in obese children comprise small patient samples or focus on those patients with liver enzyme elevation.

Objectives: We have prospectively analyzed liver enzymes in all overweight and obese children coming to our tertiary care centre.

Patients and methods: In a prospective study 224 healthy, overweight or obese children aged 1 - 12 years were examined. Body Mass Index-Standard Deviation Score, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl-transpeptidase were measured.

Results: Elevated alanine aminotransferase was observed in 29% of children. 26 % of obese and 30 % of overweight children had liver enzyme elevations. Obese children had significantly higher alanine aminotransferase levels than overweight children (0.9 vs. 0.7 times the Upper Limit of Normal; P = 0.04).

Conclusions: Elevation of liver enzymes appears in 29 % obese children in a tertiary care centre. Absolute alanine aminotransferase levels are significantly higher in obese than in overweight children. Even obese children with normal liver enzymes show signs of fatty liver disease as demonstrated by liver enzymes at the upper limit of normal.

Keywords: Child; Fatty Liver; Liver; Non-alcoholic Fatty Liver Disease; Obesity.

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Figures

Figure 1.
Figure 1.. Alanine aminotransferase/Upper Limit of Normal-Ratio (ALT)/ULN-Ratio in Correlation With Age
ALT/ratio levels above 1 are considered pathologic. The linear regression R square (Rsq) demonstrates no significant correlation of ALT/ULN and age.
Figure 2.
Figure 2.. Median and Quartiles of Ratios of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl-transpeptidase (GGT) and the upper limit of normal (ULN) (n = 224)
The difference between the median ALT in overweight and obese patients was significant. * (P = 0.04).
See this image and copyright information in PMC

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References

    1. Sanyal AJ, Campbell-Sargent C, Mirshahi F, Rizzo WB, Contos MJ, Sterling RK, et al. Nonalcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities. Gastroenterology. 2001;120(5):1183–92. doi: 10.1053/gast.2001.23256. - DOI - PubMed
    1. Donnelly KL, Smith CI, Schwarzenberg SJ, Jessurun J, Boldt MD, Parks EJ. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. J Clin Invest. 2005;115(5):1343–51. doi: 10.1172/JCI23621. - DOI - PMC - PubMed
    1. Bugianesi E, McCullough AJ, Marchesini G. Insulin resistance: a metabolic pathway to chronic liver disease. Hepatology. 2005;42(5):987–1000. doi: 10.1002/hep.20920. - DOI - PubMed
    1. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539–53. doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S. - DOI - PubMed
    1. Nobili V, Manco M. Therapeutic strategies for pediatric non-alcoholic fatty liver disease: a challenge for health care providers. World J Gastroenterol. 2007;13(18):2639–41. - PMC - PubMed

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