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. 2023 Apr 24;18(4):e0282830.
doi: 10.1371/journal.pone.0282830. eCollection 2023.

Synergistic effect of serum uric acid and body mass index trajectories during middle to late childhood on elevation of liver enzymes in early adolescence: Findings from the Ewha Birth and Growth Study

Sung Hee Lee  1 , Eun Jeong Choi  1 , Ui Jeong Kim  1   2 , Hyunjin Park  1   2 , Bomi Park  3 , Hye Ah Lee  4 , Hyesook Park  1   2
Affiliations

Synergistic effect of serum uric acid and body mass index trajectories during middle to late childhood on elevation of liver enzymes in early adolescence: Findings from the Ewha Birth and Growth Study

Sung Hee Lee et al. PLoS One. .

Abstract

Background/objectives: We aimed to determine whether serum uric acid (SUA) and body mass index (BMI) trajectories in childhood have longitudinal association with liver enzymes in adolescence.

Methods: We conducted a study using data from the Ewha Birth and Growth Cohort. Individual trajectories of SUA (n = 203) and BMI (n = 206) from 5, 7, and 9 years were defined by group-based trajectory modeling. Also, liver function enzymes were collected at 11 to 12 year of age (Aspartate Aminotransferase [AST], Alanine transaminase [ALT], and Gamma-glutamyl transferase [γ-GTP]) (n = 206). Using a generalized linear model, the effects of SUA trajectory and BMI trajectory on liver function enzymes were assessed. We also assessed the interaction effect of SUA and BMI trajectories on liver enzymes.

Results: For trajectory patterns, both SUA and BMI were classified into two distinct groups (High or Low). Both trajectory of SUA and BMI in childhood were positively associated with levels of liver enzymes at 11-12 years of age. The results showed that the combined effect of SUA and BMI trajectories on liver enzymes had a higher means in high-risk group (high SUA-high BMI trajectories group) than in low-risk group (low SUA-low BMI trajectories group) for ALT and γ-GTP, respectively. It remained significant association when adjusted for covariates. In addition, the interaction of BMI and SUA trajectories showed a significant synergistic effect.

Conclusion: Elevated childhood SUA and BMI trajectories are associated with increased liver enzymes in beginning of adolescent. This finding suggesting that early interventions in SUA and BMI may need for optimization of liver enzymes as potential marker for development of related disease in later life.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. A study hypothesis on the interaction effect of serum uric acid and BMI trajectories during childhood on liver enzymes at 11–12 years of age.
Fig 2
Fig 2. Group-based trajectory modeling used to determine distinct body mass index and serum uric acid trajectories.
BMI, Body mass index; SUA, Serum uric acid; * Serum uric acid trajectories were analyzed using standardized serum uric acid levels.
Fig 3
Fig 3. The interactions between SUA trajectory and BMI trajectory on ALT and γ- GTP in adolescent.
BMI, Body mass index; SUA, Serum uric acid; Z-score ALT, Alanine aminotransferase; γ-GTP, Gamma-glutamyl transferase. (a) The interactions between SUA trajectory and BMI trajectory on ALT at 11 to 12 years of age; (b) The interactions between SUA trajectory and BMI trajectory on γ-GTP at 11 to 12 years of age;.
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