title: Alanine aminotransferase elevation in obese infants and children: a marker of early onset non alcoholic Fatty liver disease.
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.
  
  
  OBJECTIVE
  We have prospectively analyzed liver enzymes in all overweight and obese children coming to our tertiary care centre.
  
  
  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.
authors.affiliation: Department of Pediatrics, Lukas Hospital, Neuss, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Engelmann
authors.affiliation: Department of Pediatrics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Georg Friedrich
authors.initials: GF
authors.lastname: Hoffmann
authors.affiliation: Department of Pediatrics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Grulich-Henn
authors.affiliation: Department of Pediatrics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Teufel
keywords: Child; Fatty Liver; Liver; Non-alcoholic Fatty Liver Disease; Obesity
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