title: Clinical significance of serum alanine aminotransferase and lifestyle intervention in children with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  This study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD.
  
  
  METHODS
  The clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of patients with NAFLD were also compared based on the status of ALT levels after lifestyle intervention.
  
  
  RESULTS
  Patients with elevated ALT had significantly higher body mass index (BMI) scores than those with normal ALT (P<0.05). Of all the patients with elevated ALT, 89% exhibited moderate or severe degree of fatty change in the liver on ultrasonographic examination, whereas most patients with normal ALT exhibited mild or moderate degree changes. Liver biopsy was performed in 15 children with elevated ALT and all showed mild histological changes. Of all patients with elevated ALT, 49% achieved normal ALT levels after lifestyle intervention. Those with more severe histological changes tended to have continuously increasing ALT levels. There was no correlation between the normalization of posttreatment ALT level and BMI, as well as ultrasonographic findings at diagnosis.
  
  
  CONCLUSIONS
  ALT elevation in NAFLD is highly associated with higher BMI scores and more severe degree of fatty changes on ultrasonographic examination. Lifestyle intervention can significantly improve ALT in children with NAFLD. The degree of histologic changes appears to be a predictor of the treatment response to NAFLD.
authors.affiliation: Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Kyoung Ah
authors.initials: KA
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Peter
authors.initials: P
authors.lastname: Chun
authors.affiliation: Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Park
keywords: Alanine aminotransferase; Child; Nonalcoholic fatty liver disease