Alanine aminotransferase and high sensitivity C-reactive protein: correlates of cardiovascular risk factors in youth.
OBJECTIVE
The association between high-sensitivity C-reactive protein (hs-CRP) and alanine aminotransferase (ALT) with clinical/metabolic variables was evaluated in overweight Brazilian children and adolescents.


METHODS
Oral glucose tolerance test was performed in 407 students (273 overweight/obese, 11.3 +/- 3.1 y). Measurements included body mass index (BMI), waist circumference (WC), blood pressure, lipids, insulin, hs-CRP, and ALT. Overweight/obese was defined using BMI z-score; insulin resistance (IR) by homeostatic model assessment: insulin resistance (HOMA-IR); and metabolic syndrome (MS) in accordance with the modified NCEP-ATPIII.


RESULTS
As weight increased, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), insulin, HOMA-IR, hs-CRP, ALT, ALT, hs-CRP, and AST and the number of MS components (nMSc) also increased (P </= .001 for all). Subjects with hs-CRP and ALT above the median had higher BMI z-score, WC, SBP, DBP, TG, AST, insulin, HOMA-IR, and nMSc than those with both markers below the median (P </= .002 for all). After adjustment for age, sex and ethnicity, BMI z-score (OR, 1.5; CI, 1.38 to 1.86; P < .001), WC (OR,1.3; CI, 1.19 to 1.43; P < .001) SBP (OR, 1.2; CI, 1.03 to 1.38; P = .015), DBP (OR, 1.4; CI, 1.15 to 1.69; P < .001), TG (OR, 1.8; CI, 1.29 to 2.62; P < .001), insulin (OR, 1.4; CI, 1.23 to 1.71; P < .001), HOMA-IR (OR, 1.2; CI, 1.09 to 1.29; P < .001) and nMSc (OR, 2; CI, 1.16 to 3.47; P = .012) were independently associated with high ALT and hs-CRP. For every 5-cm increase in WC and every 1-point increase in BMI z-score, there were a 1.3- and 1.5-fold greater chance of having increased ALT and hs-CRP, respectively.


CONCLUSIONS
Simultaneous measurements of ALT and hs-CRP should be considered as a screening test for metabolic syndrome and cardiovascular disease risk factors in overweight/obese children/adolescents.
Oliveira
Antônio C
AC
Bahian School of Medicine and Public Health, Science Development Foundation of Bahia, Bahia, Brazil.
Oliveira
Ana M
AM
Almeida
Marcele S
MS
Silva
Agnaluce M
AM
Adan
Luis
L
Ladeia
Ana M
AM
D000293:Adolescent; D017677:Age Distribution; D000410:Alanine Transaminase / Q000032:analysis*; D000886:Anthropometry; D015415:Biomarkers / Q000032:analysis; D001774:Blood Chemical Analysis; D001938:Brazil / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012720:Severity of Illness Index; D017678:Sex Distribution
D015415:Biomarkers; D002097:C-Reactive Protein; D000410:Alanine Transaminase