Triglycerides and alanine aminotransferase as screening markers for suspected fatty liver disease in obese children and adolescents.
OBJECTIVE
Metabolic syndrome (MS) and fatty liver disease (FLD) are on the rise. The association between these conditions in Brazilian youth is analyzed.


METHODS
354 subjects (11.2+/-3.1 years) were evaluated. FLD was suspected by ultrasound and computed tomography; weight and MS by BMI z-score and NCEP-ATPIII respectively.


RESULTS
Subjects were classified as: group 1 with suspected FLD and group 2 without and group 2 as 'a' (overweight/obese) and 'b' (normal weight). Comparing group 1 with 2a and 2b, differences in age (p=0.016; p=0.075), triglycerides (TG) (p=0.021; p=0.002), insulin (p=0.652; p=0.015) and homeostasis model assessment method of IR (HOMA-IR) (p=0.737; p=0.003) were found. Group 2a was divided into low/high alanine aminotransferase (ALT). A decrease in waist circumference and TG was found going from those with suspicion of FLD to obese with high and low ALT. Insulin and HOMA-IR in group 1 and high ALT were similar. Gender (OR 6.6; CI 1.9-22.5; p=0.025), age (OR 1.3; CI 1.1-1.6; p=0.006), TG (OR 10.4; CI 3.1-34.4; p=0.005) were associated with suspected FLD. For every 10 U/l increase in ALT, there was a 4-fold greater chance of probable FLD (OR 4.01; CI 2.06-9.40; p<0.001).


CONCLUSIONS
Measurements of ALT and TG should be considered as screening for suspected FLD in overweight/obese youth.
Oliveira
Ana M
AM
Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil. anamayra@uol.com.br
Oliveira
Nelson
N
Reis
Jussara C
JC
Santos
Marcos V
MV
Silva
Agnaluce M
AM
Adan
Luis
L
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002648:Child; D005234:Fatty Liver / Q000097:blood* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D014280:Triglycerides / Q000097:blood*
D015415:Biomarkers; D014280:Triglycerides; D000410:Alanine Transaminase