title: Prevalence and associated factors of abnormal liver values in children with celiac disease.
abstract: BACKGROUND
  The prevalence and factors associated with transaminasemia in celiac disease are poorly known.
  
  
  OBJECTIVE
  To investigate these issues in paediatric celiac patients and controls.
  
  
  METHODS
  Alanine aminotransferase (ALT) was studied in 150 children with untreated celiac disease, 161 disease controls and 500 population-based controls. The association between ALT and clinical and histological variables and the effect of a gluten-free diet were investigated in celiac patients.
  
  
  RESULTS
  ALT was >30U/l: celiac disease 14.7%, ulcerative colitis 37.2%, Crohn's disease 16.7%, reflux disease 16.2%, functional gastrointestinal symptoms 8.9%, and controls 3.6%. Factors associated with increased ALT were poor growth (45.5% vs 24.2%, P=0.039) and severe villous atrophy (median 23.0U/l vs partial atrophy 19.0U/l, P=0.008), but not age, sex, body-mass index, type or severity of symptoms and co-morbidities. ALT had a moderate correlation with endomysial (r=0.334, P<0.001) and transglutaminase antibodies (r=0.264, P=0.002) and ferritin (r=-0.225, P=0.03), but not with other laboratory values. On gluten-free diet median ALT decreased from 22.0U/l to 18.0U/l (P=0.002) and 80% of the high values normalized.
  
  
  CONCLUSIONS
  Increased ALT is associated with more advanced serological and histological celiac disease. Adherence to a gluten-free diet appears to result in normalization or reduction of ALT levels.
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Finland.
authors.forename: Linnea
authors.initials: L
authors.lastname: Äärelä
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Finland.
authors.forename: Samuli
authors.initials: S
authors.lastname: Nurminen
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Kivelä
authors.affiliation: Tampere School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.affiliation: Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Viitasalo
authors.affiliation: School of Medicine, University of Tampere, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.affiliation: Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Lakka
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. Electronic address: kalle.kurppa@uta.fi.
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood*; D001284:Atrophy; D001323:Autoantibodies / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D005387:Finland; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008099:Liver / Q000503:physiopathology; D008297:Male; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011503:Transglutaminases; D000410:Alanine Transaminase
keywords: Alanine aminotransferase; Gluten-free diet; Paediatrics; Transaminases