Triglycerides and alanine aminotransferase as screening markers for suspected fatty liver disease in obese children and adolescents.

摘要

BACKGROUND/AIMS: 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). CONCLUSION: Measurements of ALT and TG should be considered as screening for suspected FLD in overweight/obese youth.