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Villasís-Keever MÁ, Zurita-Cruz JN, Nava-Sánchez K, Barradas-Vázquez AS, López-Beltrán AL, Espíritu-Díaz ME, Delgadillo-Ruano MA. [Comparison of serum uric acid and liver enzyme levels in adolescents with obesity and with metabolic syndrome]. NUTR HOSP 2024. [PMID: 38896119 DOI: 10.20960/nh.05137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population. OBJECTIVE to compare serum liver enzyme and uric acid levels between adolescents with and without MS. METHODS a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed. STATISTICAL ANALYSIS Student's t test or the Chi-square test was used to evaluate differences between groups. RESULTS a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group. CONCLUSIONS serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.
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Affiliation(s)
- Miguel Ángel Villasís-Keever
- Unidad de Investigación en Análisis y Síntesis de la Evidencia. Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social (IMSS)
| | - Jessie Nallely Zurita-Cruz
- Facultad de Medicina. Universidad Nacional Autónoma de México. Hospital Infantil de México Federico Gómez
| | - Karla Nava-Sánchez
- Facultad de Medicina. Universidad Nacional Autónoma de Mexico. Hospital Infantil de Mexico Federico Gómez
| | - Aly Sugei Barradas-Vázquez
- Unidad de Investigación en Análisis y Síntesis de la Evidencia. Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social
| | - Ana Laura López-Beltrán
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
| | - Mireya Elizabeth Espíritu-Díaz
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
| | - Martha Alicia Delgadillo-Ruano
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
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Seo YJ, Shim YS, Lee HS, Hwang JS. Updated reference ranges for aminotransferase levels of Korean children and young adolescents based on the risk factors for metabolic syndrome. Sci Rep 2022; 12:15739. [PMID: 36131081 PMCID: PMC9492680 DOI: 10.1038/s41598-022-20104-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 09/08/2022] [Indexed: 01/19/2023] Open
Abstract
We investigated the reference values of liver enzymes based on cardiometabolic risks among children and adolescents using the Korea National Health and Nutrition Examination Survey. A total of 8091 subjects aged 10-18 years were included from the data from 2007-2017. Overall, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the AST/ALT ratio varied with sex and age. AST levels tended to decrease with age, but ALT levels had a U-shaped curve, which resulted in a gradual increase in the AST/ALT ratio after age 13. The prevalence of MetS was strongly associated with elevated AST or ALT and a decreased AST/ALT ratio. The prevalence ratios of the development of MetS were also elevated in groups with high levels of AST and ALT and a low AST/ALT ratio. Particularly in the combined ALT and AST/ALT analyses, borderline-high levels also showed a high prevalence ratio of MetS. Liver enzymes were also involved in the increase in the adjusted mean values for each risk factor for MetS. Here, we provided updated reference values for liver enzymes based on the analysis between population-based data and cardiometabolic risk factors; AST, ALT and the AST/ALT ratio might be useful in the early diagnosis and treatment of MetS.
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Affiliation(s)
- Young-Jun Seo
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, 77 Sakju-ro, Chuncheon, Gangwon-do, 24253, Republic of Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
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3
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Julian V, Bergsten P, Ennequin G, Forslund A, Ahlstrom H, Ciba I, Dahlbom M, Furthner D, Gomahr J, Kullberg J, Maruszczak K, Morwald K, Olsson R, Pixner T, Schneider A, Pereira B, Ring-Dimitriou S, Thivel D, Weghuber D. Association between alanine aminotransferase as surrogate of fatty liver disease and physical activity and sedentary time in adolescents with obesity. Eur J Pediatr 2022; 181:3119-3129. [PMID: 35771354 DOI: 10.1007/s00431-022-04539-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/26/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 ± 2.2 years, body mass index (BMI) 98.9 ± 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time. CONCLUSION Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible. WHAT IS KNOWN • MVPA and SED times are associated with cardiometabolic risks in youths with obesity. • The relationships between NAFLD markers and concomitant MVPA and SED times have not been studied in this population. WHAT IS NEW • Low SED time is associated with healthier liver enzyme profiles and LFC independent of MVPA. • While low SED/high MVPA is the more desirable pattern, low SED/low MVPA pattern would have healthier liver enzyme profile compared with high MVPA/high SED, independent of BMI, suggesting that reducing SED time irrespective of MVPA is needed to optimize liver health.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, Human Nutrition Research Center (CRNH), University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, INRA, University of Clermont Auvergne, Clermont-Ferrand, Europe, France. .,Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.,Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gael Ennequin
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Clermont-Ferrand, France
| | - Anders Forslund
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Hakan Ahlstrom
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, 431 53, Mölndal, Sweden
| | - Iris Ciba
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Dahlbom
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Dieter Furthner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Julian Gomahr
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, 431 53, Mölndal, Sweden
| | - Katharina Maruszczak
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Katharina Morwald
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Roger Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Thomas Pixner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Anna Schneider
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Bruno Pereira
- Department of Biostatistics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Clermont-Ferrand, France
| | - Daniel Weghuber
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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López-Gil JF, Ramírez-Vélez R, Alarcón-Jiménez J, Izquierdo M, García-Hermoso A. Low handgrip strength is associated with higher liver enzyme concentrations in US adolescents. Pediatr Res 2022; 91:984-990. [PMID: 33875806 DOI: 10.1038/s41390-021-01530-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/23/2021] [Accepted: 03/29/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Increasing evidence highlights the role of muscular strength as a protective factor for cardiometabolic health in adolescents. However, it is not known the relationship between liver enzyme concentrations, liver disease risk factors, and muscular strength among young populations. The aim of this study was to determine the association between muscle strength and liver enzymes and chronic liver disease risk among US adolescents. METHODS Data from the NHANES cross-sectional study (2011-2014) was used. A total of 1270 adolescents were included in the final analysis (12-17 years old). Absolute handgrip strength (kg) was normalized according to body composition parameters by body weight [NHSw], whole-body fat [NHSf], and trunk fat [NHSt]). RESULTS In boys, handgrip strength was inversely associated with higher values of aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) for all estimations of muscle strength (NHSw, NHSf, and NHSt) (p < 0.050). Likewise, boys with high and intermediate NHSw, NHSf, and NHSt presented lower AST and GGT than their counterparts with low handgrip strength (p < 0.050). CONCLUSIONS Our findings highlight the importance of muscular strength during adolescence since they could help in developing better liver enzyme profiles among adolescent population. IMPACT Our research suggests that US adolescents with low handgrip strength have higher values of liver enzymes as well as a higher prevalence of chronic liver disease. These findings are clinically meaningful and highlight the importance of muscular strength during adolescence since they could help in developing better liver enzyme profiles among young populations.
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Affiliation(s)
- José Francisco López-Gil
- Departamento de Actividad Física y Deporte, Facultad de Ciencias del Deporte, Universidad de Murcia, Murcia, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | | | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain. .,Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile.
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5
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Li Q, Zhang S, Wang H, Xue C, Zhang X, Qin S, Yuan J. Rotating night shift work, sleep duration and elevated gamma-glutamyl transpeptidase among steelworkers: cross-sectional analyses from a Chinese occupational cohort. BMJ Open 2021; 11:e053125. [PMID: 34911716 PMCID: PMC8679064 DOI: 10.1136/bmjopen-2021-053125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the separate and combined effects of rotating night shift work and lifestyle factors with elevated gamma-glutamyl transpeptidase (GGT) among steelworkers. DESIGN, SETTING AND PARTICIPANTS This cross-sectional study used the baseline information from a Chinese occupational cohort. The in-service workers of the production department of Tangsteel Company who participated in the occupational health examination in Tangshan from February to June 2017 were selected as the research objects. MAIN OUTCOME MEASURES The separate and combined effects of rotating night shift work and lifestyle factors with elevated GGT among steelworkers. RESULTS The information of 7031 subjects from the production department of Tangsteel Company was analysed. Results showed that the current shift workers and the workers with the duration of night shifts>19 years, the cumulative number of night shifts>1774 nights, the average frequency of night shifts≤7 nights/month and the average frequency of night shifts>7 nights/month had elevated odds of elevated GGT, compared with those who never worked night shifts, and ORs, (95% CIs) were 1.39, (1.10 to 1.75), 1.46, (1.15 to 1.86), 1.46, (1.15 to 1.85), 1.34, (1.04 to 1.73) and 1.37, (1.09 to 1.74) after adjustment for potential confounders. The independent effect of shorter sleep duration (<7 hours/day) on elevated GGT was not statistically significant. Among workers who had shorter sleep duration, the association between rotating night shift work and elevated GGT was statistically significant, but no associations were found among workers with the sleep duration of ≥7 hours/day. In addition, other lifestyle factors affected the association between rotating night shift work and elevated GGT. CONCLUSIONS Rotating night shift work is associated with elevated GGT among steelworkers. In particular, the effect of rotating night shift work on elevated GGT was affected by sleep duration and other lifestyle factors.
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Affiliation(s)
- Qinglin Li
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Shengkui Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Han Wang
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Chao Xue
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaohong Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Sheng Qin
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Juxiang Yuan
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
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Causative Mechanisms of Childhood and Adolescent Obesity Leading to Adult Cardiometabolic Disease: A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112311565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.
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Luo M, Fan R, Wang X, Lu J, Li P, Chu W, Hu Y, Chen X. Gualou Xiebai Banxia decoction ameliorates Poloxamer 407-induced hyperlipidemia. Biosci Rep 2021; 41:BSR20204216. [PMID: 34036306 PMCID: PMC8204229 DOI: 10.1042/bsr20204216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/20/2021] [Accepted: 05/04/2021] [Indexed: 12/30/2022] Open
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Gualou Xiebai Banxia (GLXBBX) decoction is a well-known traditional Chinese herbal formula that was first discussed in the Synopsis of the Golden Chamber by Zhang Zhongjing in the Eastern Han Dynasty. In traditional Chinese medicine, GLXBBX is commonly prescribed to treat cardiovascular diseases, such as coronary heart disease and atherosclerosis. OBJECTIVE The present study aimed to examine GLXBBX's preventative capacity and elucidate the potential molecular mechanism of Poloxamer 407 (P407)-induced hyperlipidemia in rats. MATERIALS AND METHODS Both the control and model groups received pure water, and the test group also received a GLXBBX decoction. For each administration, 3 ml of the solution was administered orally. To establish hyperlipidemia, a solution mixed with 0.25 g/kg P407 dissolved in 0.9% normal saline was injected slowly into the abdominal cavity. At the end of the study, the rats' plasma lipid levels were calculated using an automatic biochemical analyzer to evaluate the preventative capability of the GLXBBX decoction, and the serum and liver of the rats were collected. RESULTS The GLXBBX decoction significantly improved P407-induced hyperlipidemia, including increased plasma triglycerides (TGs), aspartate aminotransferase (AST) elevation, and lipid accumulation. Moreover, GLXBBX decoction treatment increased lipoprotein lipase (LPL) activity and mRNA expression of LPL. Furthermore, GLXBBX significantly suppressed the mRNA expression of stearoyl-CoA desaturase (SCD1). CONCLUSION GLXBBX significantly improved P407-induced hyperlipidemia, which may have been related to enhanced LPL activity, increased LPL mRNA expression, and decreased mRNA expression of SCD1.
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Affiliation(s)
- Mingzhu Luo
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 611137, Sichuan, China
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Rong Fan
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
- Central Laboratory, Tianjin Xiqing Hospital, Tianjin 300380, China
| | - Xiaoming Wang
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Junyu Lu
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Ping Li
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
- Department of Pharmacology Research, Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Wenbin Chu
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Yonghe Hu
- Department of Traditional Chinese Medicine, The General Hospital of Western Theater Command, Chengdu 611137, Sichuan, China
| | - Xuewei Chen
- Department of Operational Medicinal Research, Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
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Putri RR, Casswall T, Hagman E. Prevalence of increased transaminases and its association with sex, age, and metabolic parameters in children and adolescents with obesity - a nationwide cross-sectional cohort study. BMC Pediatr 2021; 21:271. [PMID: 34107897 PMCID: PMC8188660 DOI: 10.1186/s12887-021-02747-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
Background Childhood obesity increases the risk of non-alcoholic fatty liver disease marked by elevated alanine aminotransferase (ALT). This study investigated the prevalence of increased ALT in children and adolescents with obesity, and its associations with sex, age, degree of obesity, and metabolic parameters. Methods Individuals between 5 and 17.99 years of age enrolled in the Swedish Childhood Obesity Treatment Register (BORIS) before March 2020 were included. Mildly increased ALT was defined by ALT 27–51 U/L (males) and 23–43 U/L (females), while markedly increased ALT by levels above. Multiple logistic regression models were used for statistical analysis. Results Among 11,776 individuals (age 11.0 ± 3.3 years, 53.5% males), the prevalence of mildly and markedly increased ALT were 37.9 and 10.6%, respectively. A sex-age interaction was found, where increasing age strengthened the odds of markedly increased ALT in males (OR, 99% CI: 1.34, 1.29–1.4 for each year) while the corresponding pattern in females with was minuscule (1.09, 1.02–1.10). Compared to class I obesity, class II and III obesity had greater odds ratios for mildly increased ALT (class II obesity OR, 99% CI: 1.51, 1.35–1.70; class III obesity OR, 99% CI: 2.17, 1.66–2.61) and for markedly increased ALT (class II obesity OR, 99% CI: 1.82, 1.51–2.20; class III obesity OR, 99% CI 3.38, 2.71–4.23). Dyslipidemia was associated with both mildly and markedly increased ALT, all p < 0.001. Prevalence of impaired fasting glucose was 19.1% in normal ALT group, 20.4% in mildly increased ALT group, and 29.0% in markedly increased ALT group. Conclusions The risk of markedly increased ALT increased exponentially with age among boys, but not among girls. Higher degree of obesity was observed in individuals with mildly and markedly increased ALT. Further, metabolic derangements were more prevalent among individuals with mildly and markedly increased ALT.
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Affiliation(s)
- Resthie R Putri
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A, 141 57 Huddinge, Stockholm, Sweden
| | - Thomas Casswall
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A, 141 57 Huddinge, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A, 141 57 Huddinge, Stockholm, Sweden.
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9
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Jia J, Yang Y, Liu F, Zhang M, Xu Q, Guo T, Wang L, Peng Z, He Y, Wang Y, Zhang Y, Zhang H, Shen H, Zhang Y, Yan D, Ma X, Zhang P. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovasc Disord 2021; 21:145. [PMID: 33740888 PMCID: PMC7980597 DOI: 10.1186/s12872-021-01948-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.
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Affiliation(s)
- Jiajing Jia
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Ying Yang
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China. .,China DOHaD Research Center, Beijing, People's Republic of China.
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, Beijing, People's Republic of China.,National Center for Cardiovascular Disease, Beijing, People's Republic of China.,China Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Minjin Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Qin Xu
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Tonglei Guo
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Long Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, People's Republic of China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuan He
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China.,China DOHaD Research Center, Beijing, People's Republic of China
| | - Ya Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Xu Ma
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China.
| | - Puhong Zhang
- Diabetes Research Program, The George Institute for Global Health At Peking University Health Science Center, Zhi Chun Road, 6#, Beijing, People's Republic of China.
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10
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Chen Y, Ou W, Lin D, Lin M, Huang X, Ni S, Chen S, Yong J, O'Gara MC, Tan X, Liu R. Increased Uric Acid, Gamma-Glutamyl Transpeptidase and Alkaline Phosphatase in Early-Pregnancy Associated With the Development of Gestational Hypertension and Preeclampsia. Front Cardiovasc Med 2021; 8:756140. [PMID: 34722684 PMCID: PMC8554001 DOI: 10.3389/fcvm.2021.756140] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/21/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Previous studies have reported that biomarkers of liver injury and renal dysfunction were associated with hypertensive disorders of pregnancy (HDP). However, the associations of these biomarkers in early pregnancy with the risk of HDP and longitudinal blood pressure pattern during pregnancy were rarely investigated in prospective cohort studies. Methods: A total of 1,041 pregnant women were enrolled in this prospective cohort study. BP was assessed in four stages throughout pregnancy. The following biomarkers were measured at early pregnancy before 18 weeks gestation: lactate dehydrogenase (LDH), aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), uric acid (UA), and estimated glomerular filtration rate (eGFR). Linear mixed-effects and logistic regression models were used to examine the associations of these biomarkers with longitudinal BP pattern during pregnancy and HDP incidence, respectively. Results: In unadjusted models, higher serum UA, GGT, ALP, and LDH levels, as well as lower eGFR and AST/ALT, were associated with higher BP levels during pregnancy and an increased risk of HDP. After adjustment for maternal age, pre-pregnancy BMI and other potential confounders, UA, GGT, ALP, and LDH remained positively associated with both BP and HDP. However, eGFR and AST/ALT were not associated with HDP after adjusting for potential confounders. When including all 6 biomarkers simultaneously in multivariable analyses, increased UA, GGT, and ALP significantly associated with gestational hypertension and preeclampsia. Conclusion: This study suggests that increased UA, GGT, and ALP in early-pregnancy are independent risk factors of gestational hypertension and preeclampsia.
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Affiliation(s)
- Yequn Chen
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Weichao Ou
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Dong Lin
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Mengyue Lin
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Xiru Huang
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Shuhua Ni
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shaoxing Chen
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jian Yong
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | | | - Xuerui Tan
- First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
- *Correspondence: Xuerui Tan
| | - Ruisheng Liu
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States
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11
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Qorbani M, Khashayar P, Rastad H, Ejtahed HS, Shahrestanaki E, Seif E, Daniali SS, Goudarzi M, Motlagh ME, Khodaparast Z, Heshmat R, Kelishadi R. Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children and adolescents. Diabetol Metab Syndr 2020; 12:108. [PMID: 33372634 PMCID: PMC7720466 DOI: 10.1186/s13098-020-00617-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/23/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND AIMS To examine the association of dietary behaviors, lifestyle, and biochemical factors with metabolic phenotypes of obesity among obese Iranian children and adolescents. METHODS This cross-sectional study was conducted within the framework of the fifth phase of CASPIAN study. Of 3840 students aged 7-18 years of 30 Iranian provinces, 408 subjects were diagnosed as obese; they were divided into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) groups. Biochemical factors, anthropometric measures, dietary, and lifestyle habits were compared between groups. RESULTS Of the 408 obese subjects, 68 (16.7%) were the MUO; the remaining 340 (84.3%) fall in the MHO group. The MUO group had significantly higher systolic and diastolic BPs, FBS, TG, ALT, anthropometric measures, and lower HDL levels than MHO groups (all p-value < 0.05). The frequency of high birth weight (> 4000 gr) was significantly higher in the MUO group than the MHO group (p-value: 0.04). A higher percentage of individuals with breastfeeding duration ≥ 6 month was found in the MUO group (95.5% (95% CI 86.1-98.6%)) compared to MHO group (85.7% (95% CI 80.4-89.7%)) (p-value = 0.04). Among dietary and lifestyle-related behaviors, only the frequency of salty snack consumption and eating food according to the parents' request was significantly higher in the MUO group than the MHO group (p-value < 0.05). CONCLUSION Dietary habits and lifestyle factors may determine the obesity phenotypes in children and adolescents.
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Affiliation(s)
- Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 111, 19th St., North Kargar Ave, Tehran, Iran
| | - Pouria Khashayar
- Cardiovascular Department, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hadith Rastad
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Shahrestanaki
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyede Shahrbanoo Daniali
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran
| | - Masoomeh Goudarzi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran
| | | | - Zeinab Khodaparast
- Clinical Research Development Center of Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 111, 19th St., North Kargar Ave, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Ave, Isfahan, Iran.
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12
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Ochiai H, Shirasawa T, Yoshimoto T, Nagahama S, Watanabe A, Sakamoto K, Kokaze A. Elevated alanine aminotransferase and low aspartate aminotransferase/alanine aminotransferase ratio are associated with chronic kidney disease among middle-aged women: a cross-sectional study. BMC Nephrol 2020; 21:471. [PMID: 33172399 PMCID: PMC7653768 DOI: 10.1186/s12882-020-02144-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. METHODS The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. RESULTS "Elevated ALT and elevated GGT" and "elevated ALT and non-elevated GGT" significantly increased the OR for CKD when compared with "non-elevated ALT and non-elevated GGT" (OR: 2.56, 95% CI: 2.10-3.12 and OR: 2.24, 95% CI: 1.81-2.77). Compared with "AST/ALT ratio ≥ 1 and non-elevated GGT", "AST/ALT ratio < 1 and elevated GGT" and "AST/ALT ratio < 1 and non-elevated GGT" significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36-3.15 and OR: 1.68, 95% CI: 1.52-1.87). These findings still remained after adjustment for confounders. CONCLUSIONS Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.
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Affiliation(s)
- Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Satsue Nagahama
- All Japan Labor Welfare Foundation, 6-16-11 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan
| | - Akihiro Watanabe
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Ken Sakamoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
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13
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Medrano M, Arenaza L, Migueles JH, Rodríguez-Vigil B, Ruiz JR, Labayen I. Associations of physical activity and fitness with hepatic steatosis, liver enzymes, and insulin resistance in children with overweight/obesity. Pediatr Diabetes 2020; 21:565-574. [PMID: 32237015 DOI: 10.1111/pedi.13011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/29/2020] [Accepted: 03/18/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease is the most common liver disease in childhood and is related to insulin resistance and cardiometabolic risk factors. Evidence supporting the association of fitness and physical activity with hepatic fat, liver enzymes, or triglyceride-to-high-density lipoprotein ratio is scarce in children. OBJECTIVE To analyze the associations of physical fitness and physical activity (PA) with percentage hepatic fat, liver enzymes, insulin resistance, and cardiometabolic risk in children with overweight/obesity. SUBJECTS A total of 115 children (10.6 ± 1.1 years; 54% girls) with overweight/obesity of the EFIGRO study (ClinicalTrials.gov: NCT02258126) were included in the analyses. METHODS Cardiorespiratory fitness (CRF), musculoskeletal fitness and speed-agility were measured by the Alpha-fitness tests, and PA by wGT3X-BT accelerometers. Percentage hepatic fat was assessed by magnetic resonance imaging. Alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), insulin, glucose, triglycerides (TG), and high-density lipoprotein (HDL) levels were obtained from fasting blood samples. The homeostasis model assessment insulin resistance (HOMA-IR) and AST/ALT and TG/HDL ratios were calculated. RESULTS Higher CRF was associated with lower percentage hepatic fat (β = -0.266, P = .01) and GGT (β = -0.315, P < .01), and higher AST/ALT ratio (β = 0.306, P < .01). CRF-fit children have lower GGT levels (15 ± 1 vs 17 ± 1 U/L, CRF-fit vs CRF-unfit children, P = .02), HOMA-IR (2.2 ± 0.1 vs 2.9 ± 0.1, P < .01) and TG/HDL ratio (1.4 ± 0.1 vs 1.9 ± 0.1, P = .01) and higher AST/ALT ratio (1.3 ± 0.0 vs 1.2 ± 0.0, P = .03), than CRF-unfit children. CONCLUSIONS These findings emphasize the importance of considering the improvement of CRF as a target of programs for preventing hepatic steatosis, type 2 diabetes and cardiovascular diseases in children with overweight.
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Affiliation(s)
- María Medrano
- Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Lide Arenaza
- Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Jairo H Migueles
- PROmoting FITness and Health through physical activity research group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Beatriz Rodríguez-Vigil
- Department of Magnetic Resonance Imaging, Osatek, University Hospital of Alava, Vitoria, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Idoia Labayen
- Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
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14
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Lu CW, Lin MS, Lin YS, Chang IJ, Tsai MH, Wei KL, Chen MY. Aminotransferase Ratio Is a Useful Index for Hepatosteatosis in Children and Adolescents: A Cross-Sectional Observational Study. Gastroenterol Nurs 2020; 42:486-495. [PMID: 31770351 DOI: 10.1097/sga.0000000000000389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) and childhood obesity are emerging global health issues. The aim of this study was to identify a simple predictor of NAFLD in children and adolescents. This community-based study was conducted from December 2012 to September 2013 in Taiwan and included 1,222 children between 10 and 19 years of age. After excluding alcohol consumption and hepatic-related lesions, NAFLD was diagnosed according to sonographic criteria. Potential confounding factors (including age, gender, and anthropometric and laboratory data) were tested by logistic regression analysis. The cutoff value was determined using receiver operating characteristic (ROC) curve analysis. In addition to older age, heavier weight, and wider waist, subjects with NAFLD had significantly higher blood pressure, lipid disturbances, and alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratios. The correlation between NAFLD and ALT/AST ratio remained significant even after adjusting for confounders (adjusted odds ratio [OR], 2.19; 95% confidence interval [CI], 1.24-3.87; p = .007). The risk score of having a fatty liver, based on ALT/AST ratio, was greater than 0.981 according to ROC curve analysis (sensitivity, 60.5%; specificity, 80.3%; area under the curve, 0.756; CI, 0.71-0.80; p < .001). Therefore, ALT/AST ratio may represent a powerful index of hepatosteatosis in children and adolescents.
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Affiliation(s)
- Cheng-Wei Lu
- Cheng-Wei Lu, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Shyan Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan. Yu-Sheng Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. I-Jen Chang, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Horng Tsai, MD, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan. Kuo-Liang Wei, MD, Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Chiayi, Taiwan. Mei-Yen Chen, PhD, Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan; Research Fellow, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan; and Department of Nursing, Chang Gung University, Taoyuan, Taiwan
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15
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Medrano M, Arenaza L, Ramírez-Vélez R, Ortega FB, Ruiz JR, Labayen I. Prevalence of responders for hepatic fat, adiposity and liver enzyme levels in response to a lifestyle intervention in children with overweight/obesity: EFIGRO randomized controlled trial. Pediatr Diabetes 2020; 21:215-223. [PMID: 31778277 DOI: 10.1111/pedi.12949] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/26/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE Exercise and lifestyle interventions have been shown to reduce hepatic fat (HF) and adiposity in youth. However, the interindividual response in HF after a lifestyle intervention with or without exercise in children is unknown. The aim of the present study was to compare interindividual variability for HF, adiposity, gamma-glutamyl transferase (GGT), and the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) in children with overweight/obesity participating in a 22-week lifestyle intervention with (intensive intervention) or without exercise (control intervention). METHODS Data from 102 children (9-12 years, 55% girls) with overweight/obesity participating in the EFIGRO randomized controlled trial were analyzed. Percentage HF (magnetic resonance imaging), weight, body and fat mass index (BMI and FMI), GGT, AST/ALT, cardiorespiratory fitness (CRF, 20 meters shuttle run test) were assessed before and after the intervention by the same trained researchers. The control intervention consisted in 11 sessions of a family-based lifestyle and psycho-educational program. The intensive intervention included the control intervention plus supervised exercise (3 sessions/week). RESULTS The prevalence of responders for HF (54% vs. 34%), weight (27% vs. 11%), BMI (71% vs. 47%), FMI (90% vs. 60%), and GGT (69% vs. 39%) was higher in the intensive than in the control group (Ps < 0.05). Responders for weight (16 ± 3 vs. 6 ± 2 laps) and BMI (11 ± 2 vs. 3 ± 4 laps) improved more CRF levels than non-responders (Ps < 0.05). CONCLUSIONS The addition of exercise to a lifestyle intervention may increase the responder rates for HF, adiposity, and GGT in children with overweight/obesity. Improvements in CRF may explain differences between weight and BMI responders and non-responders. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02258126.
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Affiliation(s)
- María Medrano
- ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Lide Arenaza
- ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed-Universidad Pública de Navarra (UPNA)-Complejo Hospitalario de Navarra (CHN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Idoia Labayen
- ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarra, Pamplona, Spain
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16
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Chen J, Wang H, He Z, Li T. Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation. Neuropsychiatr Dis Treat 2020; 16:1645-1652. [PMID: 32753870 PMCID: PMC7343290 DOI: 10.2147/ndt.s254920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/17/2020] [Indexed: 01/29/2023] Open
Abstract
PURPOSE The study aimed to analyze the incidence of postoperative delirium (POD) and associated risk factors after liver transplantation (LT). PATIENTS AND METHODS We identified and enrolled patients undergoing LT at the Second Xiangya Hospital, Central South University between August 2018 and May 2019. We abstracted their relevant clinical information and assigned the patients into a POD group and non-POD group to compare differences in clinical information. Risk factors of POD were analyzed using logistic regression. RESULTS A total of 159 LT patients were enrolled. Forty-two patients exhibited delirium (26.4%). Of the 42 with delirium, 33 (78.6%) had delirium within 3 days postoperatively and a median duration of 5 days (quartile 3-7 days). The results of binary logistic regression are as follows: preoperative ammonia (≥46 vs <46 μmol/L; OR 3.51, 95% CI [1.31-9.46], P<0.05), Model for End-Stage Liver Disease (MELD) score (≥15 vs.<15; OR 3.33, 95% CI [1.27-8.79], P<0.05), presence of hepatic encephalopathy (OR 3.30, 95% CI [1.20-9.07], P<0.05), aspartate aminotransferase (AST) on day 1 postoperatively (OR 1.33, 95% CI [1.06 -1.68], P<0.05), anhepatic period (OR 1.04, 95% CI [1.02 -1.06], P<0.01). The POD group had a longer intubation time (2925.0 vs 1410.0 min, P<0.01), ICU length of stay (6 vs 4 d, P<0.01) and increased medical costs (43.96 vs 33.74 ten thousand yuan, P<0.01). CONCLUSION The incidence of POD in LT patients is a significant clinical feature. Ammonia ≥46 μmol/l, MELD score ≥15, hepatic encephalopathy, anhepatic period, and AST at 1 day postoperatively were independent risk factors for POD.
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Affiliation(s)
- Junguo Chen
- Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Hao Wang
- Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Zhijun He
- Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Ting Li
- Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
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17
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The effect of liver enzymes on adiposity: a Mendelian randomization study. Sci Rep 2019; 9:16792. [PMID: 31727910 PMCID: PMC6856156 DOI: 10.1038/s41598-019-52489-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 10/11/2019] [Indexed: 12/24/2022] Open
Abstract
Poorer liver function is positively associated with diabetes in Mendelian randomization (MR) studies. Observationally, adiposity is associated with poorer liver function. To clarify the etiology, we assessed the association of liver enzymes with adiposity observationally and using two-sample MR for validation. In the "Children of 1997" birth cohort, we used multivariable linear regression to assess the associations of alanine transaminase (ALT) and alkaline phosphatase (ALP) at ~17.5 years with body mass index (BMI) (n = 3,458). Using MR, genetic predictors of ALT, ALP and gamma glutamyltransferase (GGT), were applied to genome-wide association studies of BMI (n = 681,275), waist circumference (WC) (n = 224,459) and waist-hip ratio (WHR) (n = 224,459) to obtain unconfounded estimates. Observationally, ALT was positively associated with BMI (0.10 kg/m2 per IU/L, 95% confidence interval (CI) 0.09 to 0.11). ALP was inversely associated with BMI (-0.018 kg/m2 per IU/L, 95% CI -0.024 to -0.012). Using MR, ALT was inversely associated with BMI (-0.14 standard deviation per 100% change in concentration, 95% CI -0.20 to -0.07), but not WC or WHR. ALP and GGT were unrelated to adiposity. Poorer liver function might not cause adiposity; instead higher ALT might reduce BMI, raising the question as to the role of ALT in body composition.
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Nebhinani N, Sharma P, Pareek V, Suthar N, Jakhotia S, Gehlot M, Purohit P. Association of Inflammatory and Liver Markers with Cardiometabolic Risk Factors in Patients with Depression. Indian J Clin Biochem 2019; 34:219-224. [PMID: 31092997 DOI: 10.1007/s12291-018-0738-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 02/08/2018] [Indexed: 11/27/2022]
Abstract
Metabolic syndrome (MS) is found to be more prevalent in patients with psychiatric disorders including depression. This study aimed to assess the association of inflammatory and liver markers with cardiometabolic risk factors in patients with Depressive disorders. Prevalence of MS by using Modified NCEP ATP-III Criteria and liver enzymes and CRP were assessed in 382 patients with depressive disorders. MS prevalence was 27.7% and lower HDL level was the commonest metabolic abnormality. ALT, GGT, and CRP levels were positively correlated with weight and BMI. ALT, GGT, and CRP levels were significantly greater in patients with abnormal waist circumference, triglyceride levels and raised blood pressure, compared to patients with normal indices. Such association was not found with abnormal HDL cholesterol and hyperglycemia. Levels of GGT and CRP were significantly greater in patients with MS compared to patients without MS and CRP was significant predictor for MS. To conclude, one-fourth of depressed patients had MS. MS and metabolic abnormalities were associated with inflammatory marker and liver enzymes. Patients with depression should be regularly evaluated for cardiovascular risk factors, liver enzymes, and inflammatory markers.
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Affiliation(s)
- Naresh Nebhinani
- 1Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Praveen Sharma
- 2Department of Biochemistry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Vrinda Pareek
- 1Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Navratan Suthar
- 1Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Shobhan Jakhotia
- 1Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Mukesh Gehlot
- 1Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
| | - Purvi Purohit
- 2Department of Biochemistry, All India Institute of Medical Science, Jodhpur, Rajasthan 342005 India
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Mazidi M, Katsiki N, Mikhailidis DP, Banach M. Ideal cardiovascular health associated with fatty liver: Results from a multi-ethnic survey. Atherosclerosis 2018; 284:129-135. [PMID: 30878840 DOI: 10.1016/j.atherosclerosis.2018.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Little is known about the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The ideal cardiovascular health (CVH) score proposed by the American Heart Association (AHA) can be used to predict mortality and morbidity. We investigated the association of the CVH score with liver enzymes and the risk of non-alcoholic fatty liver disease (NAFLD) among US adults. METHODS By using the National Health and Nutrition Examination Survey database (cross-sectional), the CVH score was calculated as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity and diet adherence) and 3 factors (total cholesterol, blood pressure and fasting glucose). RESULTS Individuals with a higher CVH score ("better CVH") had a more favorable profile of liver biomarkers. Adjusted (for age, gender, race, poverty to income ratio, education, marital status and alcohol intake) linear regression indicated significant and negative associations between liver biomarkers and CVH score: (β = -0.069, p < 0.001) for alanine aminotransferase, (β = -0.095, p < 0.001), aspartate aminotransferase, (β = -0.067, p < 0.001), alkaline phosphatase and (β = -0.125, p < 0.001) and fatty liver index. In the logistic regression, with the same confounders, individuals with a higher CVH score had 12% less likelihood of NAFLD compared with those with a lower score. Furthermore, each CVH metric separately was inversely linked to the risk of NAFLD. CONCLUSIONS For the first time among US adults, our findings shed light on the role CVH on liver biomarkers.
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Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, China; Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), Chaoyang, China.
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Kelishadi R, Qorbani M, Heshmat R, Motamed-Gorji N, Motlagh ME, Ziaodini H, Taheri M, Shafiee G, Aminaee T, Ahadi Z, Heidari-Beni M. Association of alanine aminotransferase concentration with cardiometabolic risk factors in children and adolescents: the CASPIAN-V cross-sectional study. SAO PAULO MED J 2018; 136:511-519. [PMID: 30892481 PMCID: PMC9897142 DOI: 10.1590/1516-3180.2018.0161161118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/16/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND It has been suggested that the levels of some liver enzymes, and especially alanine aminotransferase (ALT), might be correlatable with cardiometabolic risk factors. We investigated the relationship between ALT concentration and cardiometabolic risk factors among children and adolescents. DESIGN AND SETTING This nationwide study in Iran was conducted within the framework of the fifth survey of a national surveillance program known as the Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable disease study (CASPIAN-V). METHODS The participants comprised 4200 students aged 7-18 years, who were recruited through multi-stage random cluster sampling in 30 provinces in Iran. Physical examinations and laboratory tests were conducted in accordance with standard protocols. RESULTS Overall, 3843 students (participation rate: 91.5%) completed the survey. Mean ALT levels were significantly higher in individuals with dyslipidemia, in terms of elevated total cholesterol (TC) or LDL-cholesterol or triglycerides (TG), excess weight and dyslipidemia. Some cardiometabolic risk factors were associated with higher levels of ALT, with the following odds ratio (OR) and 95% confidence interval (CI):metabolic syndrome (OR: 1.013; 95% CI: 1.001-1.025); elevated TC (OR: 1.060; 95% CI: 1.039-1.081), elevated LDL (OR: 1.031; 95% CI: 1.016-1.046), elevated TG (OR: 1.056; 95% CI: 1.040-1.072) and dyslipidemia (OR: 1.051; 95% CI: 1.034-1.068). CONCLUSION This large population-based study revealed that some cardiometabolic risk factors were significantly associated with ALT levels. These findings suggest that an association with fatty liver is an underlying mechanism for development of cardiometabolic risk factors.
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Affiliation(s)
- Roya Kelishadi
- MD. Professor, Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mostafa Qorbani
- PhD. Epidemiologist andAssistant Professor,Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; and Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Heshmat
- MD. Associate Professor, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nazgol Motamed-Gorji
- MD.Researcher,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Esmaeil Motlagh
- MD. Professor, Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hasan Ziaodini
- MD. Researcher, Office of Health and Fitness, Ministry of Education, Tehran, Iran.
| | - Majzoubeh Taheri
- MD. Pediatrician and Researcher, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran.
| | - Gita Shafiee
- MD. Researcher, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tahereh Aminaee
- BSc. Researcher, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran.
| | - Zeinab Ahadi
- MSc. Researcher, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Motahar Heidari-Beni
- PhD. Nutritionist and Assistant Professor, Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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García-Hermoso A, Hackney AC, Ramírez-Vélez R. Ideal cardiovascular health predicts lower risk of abnormal liver enzymes levels in the Chilean National Health Survey (2009-2010). PLoS One 2017; 12:e0185908. [PMID: 29049384 PMCID: PMC5648121 DOI: 10.1371/journal.pone.0185908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/21/2017] [Indexed: 12/12/2022] Open
Abstract
High levels of gamma glutamyltransferase (gamma-GT) and alanine aminotransferase (ALT), as well as fatty liver index (FLI) has been associated with higher cardiovascular disease risk factors in adults. The aim of this study was to examine the relationship between gamma-GT, ALT, and fatty liver index FLI levels across a gradient number of ideal cardiovascular health metrics in a representative sample of adults from the Chilean National Health Survey 2009-2010. Data from 1,023 men and 1,449 women (≥ 15 years) from the Chilean Health Survey 2009-2010 were analyzed. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet adherence) and three factors (total cholesterol, blood pressure and fasting glucose). Adults were grouped into three categories according to their number of ideal cardiovascular health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). Blood levels of gamma-GT and ALT were measured and the FLI was calculated. A higher number of ideal cardiovascular health index metric was associated with lower gamma-GT, ALT and FLI (p from trend analysis <0.001). Also, adults meeting at least 3-4 metrics were predicted less likely to have prevalence of abnormal levels of gamma-GT and FLI (p<0.001) compared to adults who met only 0-2 metrics. These findings reinforce the usefulness of the ideal cardiovascular health metrics proposed by the American Heart Association as a tool to identify target subjects and promote cardiovascular health in South-American adults.
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Affiliation(s)
- Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Anthony C. Hackney
- Endocrine Section-Applied Physiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA». Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C, Colombia
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Seo JY, Kim JH. Validation of surrogate markers for metabolic syndrome and cardiometabolic risk factor clustering in children and adolescents: A nationwide population-based study. PLoS One 2017; 12:e0186050. [PMID: 29049309 PMCID: PMC5648147 DOI: 10.1371/journal.pone.0186050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/25/2017] [Indexed: 02/06/2023] Open
Abstract
Prevalence of metabolic syndrome (MetS) in children is increasing and identifying the risk factors for MetS during childhood is an important first step to prevent chronic diseases later in life. The aim of the present study was to evaluate the prevalence of MetS and cardiometabolic risk factor (CMRF) clustering among Korean children and adolescents and to validate the associated anthropometric and laboratory surrogate markers. We used data from the 2011–2014 Korean National Health and Nutrition Examination Survey. In total, data for 2,935 subjects (1539 boys, 52.6%) aged 10–19 years were assessed. MetS was defined by central obesity plus any two or more of CMRFs such as abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and decreased high density lipoprotein cholesterol (HDL-C) using the International Diabetes Federation criteria for children and adolescents. The presence of two or more CMRFs was classified as CMRF clustering. The prevalence of MetS and CMRF clustering in this group was found to be 1.8% and 8.9%, respectively. The receiver operating characteristic analysis of MetS and CMRF clustering, and the area under the curve (95% confidence interval) of surrogate markers revealed that the waist circumference to height ratio [0.960 (95% CI 0.959–0.960), cut-off 0.491] showed the highest predictability for MetS whereas triglyceride to HDL-C ratio [0.891 (95% CI 0.891–0.892), cut-off 2.63] showed the highest predictability for CMRF clustering. Long-term follow-up is needed for further validation.
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Affiliation(s)
- Ji-Young Seo
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
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Aldhoon-Hainerová I, Hainer V, Zamrazilová H. Impact of dietary intake, lifestyle and biochemical factors on metabolic health in obese adolescents. Nutr Metab Cardiovasc Dis 2017; 27:703-710. [PMID: 28693964 DOI: 10.1016/j.numecd.2017.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/09/2017] [Accepted: 05/08/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Obesity devoid of metabolic abnormalities is known as metabolically healthy obesity (MHO). The aim of the study was to examine determinants of MHO during adolescence. METHODS AND RESULTS From among 710 obese adolescents, 43 girls and 57 boys were classified as metabolically unhealthy (abdominal obesity and ≥2 risk components of metabolic syndrome). MHO (absence of any cardiometabolic risk factor) was found in 211 girls and 131 boys (regardless of waist circumference) and in 33 girls and 27 boys (without abdominal obesity). Laboratory and anthropometric parameters, dietary records and various lifestyle factors were compared between MHO vs. those unhealthy. The prevalence of MHO regardless of waist circumference was higher in girls than in boys (53.1 vs. 41.9%) but comparable when abdominal obesity was excluded (8.3 vs. 8.6%). Anthropometric variables, levels of gamma-glutamyl transferase, total and low-density lipoprotein cholesterol in both genders, hs-C-reactive protein in girls and alanine aminotransferase in boys differentiated the two metabolic phenotypes. Uric acid was related to metabolic health only in the analysis of MHO without abdominal obesity. Total hours of sleep, bedtime, time of the last daily meal, regular meal consumption and protein intake in boys and screen time, the score of disinhibition and diet composition in girls were found to impact cardiometabolic health. CONCLUSIONS In obese adolescents, metabolic health was related to anthropometric and biochemical parameters and only weak associations were found with most of the lifestyle factors studied. Uric acid concentration associated with metabolic health when abdominal obesity was excluded.
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Affiliation(s)
- I Aldhoon-Hainerová
- Institute of Endocrinology, Prague, Czech Republic; Department of Pediatrics, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - V Hainer
- Institute of Endocrinology, Prague, Czech Republic
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Labayen I, Ruiz JR, Huybrechts I, Ortega FB, Castillo M, Sjöstrom M, González-Gross M, Manios Y, Widhalm K, Kafatos A, Breidenassel C, Rodríguez G, Dallongeville J, Gottrand F, Moreno LA. Ideal cardiovascular health and liver enzyme levels in European adolescents; the HELENA study. J Physiol Biochem 2017; 73:225-234. [PMID: 28063097 DOI: 10.1007/s13105-016-0546-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 12/26/2016] [Indexed: 12/16/2022]
Abstract
There is an increasing interest for the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The American Heart Association (AHA) described the ideal cardiovascular health concept as a score of seven cardiovascular health behaviors and factors that can be used to monitor and predict ideal cardiovascular health over time. This study aimed to examine the association of the ideal cardiovascular health (ICH), as defined by the AHA, with liver enzyme levels in European adolescents. A total of 637 adolescents (54.6% females), aged 14.6 ± 1.2 years from nine European countries participated in this cross-sectional study. Blood levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase were measured and the AST/ALT ratio calculated. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviors (smoking, body mass index, physical activity, and diet) and three factors (total cholesterol, blood pressure, and glucose). A higher number of ideal cardiovascular health behaviors, factors, and ideal cardiovascular health index were associated with lower ALT (P < 0.05, P < 0.001, and P < 0.001, respectively) and gamma-glutamyltransferase (P < 0.001, P < 0.01, and P < 0.001, respectively) levels. Similarly, a higher number of ideal cardiovascular health behaviors (P < 0.01), factors (P < 0.01), and ideal cardiovascular health index (P < 0.001) were associated with a higher aspartate aminotransferase to alanine aminotransferase ratio. These findings reinforce the usefulness of the ICH index as an instrument to identify target individuals and promote cardiovascular health in adolescents, and it also extends these observations to the liver manifestation of the metabolic syndrome.
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Affiliation(s)
- Idoia Labayen
- Department of Nutrition and Food Sciences, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain.
- Nutrition, Exercise and Health Research Group, Elikadura, Ariketa Fisikoa eta Osasuna, ELIKOS Group, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain.
| | - Jonatan R Ruiz
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium
- International Agency for Research on Cancer, Dietary Exposure Assessment Group, Lyon, France
| | - Francisco B Ortega
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Manuel Castillo
- Departament of Physiology, Medicine School, University of Granada, Granada, Spain
| | - Michael Sjöstrom
- Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Marcela González-Gross
- Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Kurt Widhalm
- Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | | | - Gerardo Rodríguez
- Department of Pediatrics, University of Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Jean Dallongeville
- INSERM, U744, Univ Lille Nord de France, Institut Pasteur de Lille, F-59000, Lille, France
| | - Frédéric Gottrand
- Department of Pediatrics, Jeanne de Flandre Children's University Hospital, Lille, France
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Cardiorespiratory fitness, waist circumference and liver enzyme levels in European adolescents: The HELENA cross-sectional study. J Sci Med Sport 2017; 20:932-936. [PMID: 28483561 DOI: 10.1016/j.jsams.2017.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 02/15/2017] [Accepted: 04/16/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVES (1) To examine whether cardiorespiratory fitness (CRF) is related to liver enzyme levels independent of waist circumference (WC), and (2) To test whether having a high CRF is associated with an improved liver enzyme profile with a high WC. DESIGN Cross-sectional. METHODS CRF (20m-shuttle-run test) and WC were assessed in 811 European adolescents (48.5% males) aged 12.5-17.5 years. Fatty liver biomarkers included fasting serum alanine-aminotransferase (ALT), gamma-glutamyl-transpeptidase (GGT) and the aspartate-aminotransferase to ALT (AST/ALT) ratio. Participants were categorized as fit or unfit (CRF below or above 43.8mL/kg/min and 34.6mL/kg/min, for boys and girls, respectively) and as high or non-high WC (sex and age-specific cut-offs). RESULTS CRF was associated with ALT (β=-0.106; p=0.049) and GGT levels (β=-0.225; p<0.001) and AST/ALT ratio (β=0.234; p<0.001), yet these relationships were attenuated after further controlling for WC (all p>0.1). High WC and fit adolescents had lower ALT levels (28±1U/L vs. 23±2U/L, unfit and fit respectively, p=0.018) and higher AST/ALT ratio (0.94±0.04 vs. 1.10±0.06, unfit and fit respectively, p=0.010) than those who were high WC but unfit. CONCLUSIONS The results showed that CRF is not independently associated with liver enzymes, and that WC is a stronger predictor in adolescents. These findings also suggest that high CRF may have specific protective effects on liver enzyme levels in adolescents with high WC. Exercise programs focused on increasing CRF and decreasing abdominal adiposity could be a good alternative in the treatment and prevention of obesity related fatty liver disease in adolescents.
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Bibiloni MDM, Salas R, Nuñez GM, Villarreal JZ, Sureda A, Tur JA. Relation between Liver Transaminases and Dyslipidaemia among 2-10 y.o. Northern Mexican Children. PLoS One 2016; 11:e0155994. [PMID: 27203747 PMCID: PMC4874541 DOI: 10.1371/journal.pone.0155994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 05/06/2016] [Indexed: 01/08/2023] Open
Abstract
Background and Aims The increase in overweight and obese children may be linked to increased rates of liver damage and dyslipidaemia. This study aimed to explore the associations of liver biomarkers with overweight/obesity and dyslipidaemia in Mexican children. Methods The study was a population-based cross-sectional nutritional survey carried out in the State of Nuevo León, Mexico. The study included a 414 subjects aged between 2 and 10 years old (47.8% girls) who took part in the State Survey of Nutrition and Health–Nuevo León 2011/2012. Associations between alanine aminotransferase (ALT) and aspartate aminotransferase (AST), ALT/AST ratio, and major components of serum lipid profile were assessed. Results Children with high ALT (defined as ≥P75) showed higher prevalence of dyslipidaemia than their counterparts, with high prevalence of high TChol (P = 0.053), non-HDL-chol, TG, and low HDL-chol. Children with an AST/ALT ≥T3 ratio were 0.43-times (95% CI: 0.25–0.74) and 0.27-times (95% CI: 0.17–0.44) low likely to be overweight/obese and to have dyslipidaemia than those with an AST/ALT <T1 ratio, respectively. The risk of high TChol, LDL-chol, non-HDL-chol and TG, and low HDL-chol levels also decreased in AST/ALT ratio groups. Conclusions Our results pose the need for further investigation on whether AST/ALT may be useful as screening test in the assessment of children with cardiometabolic risk.
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Affiliation(s)
- Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, E-28029, Madrid, Spain
| | - Rogelio Salas
- Faculty of Public Health Nutrition, Autonomous University of Nuevo León, 64460, Monterrey, Mexico
| | - Georgina M. Nuñez
- Faculty of Public Health Nutrition, Autonomous University of Nuevo León, 64460, Monterrey, Mexico
| | | | - Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, E-28029, Madrid, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, E-28029, Madrid, Spain
- * E-mail:
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Ehala-Aleksejev K, Punab M. Serum hepatic enzyme activity in relation to semen quality and serum reproductive hormone levels among Estonian fertile Men. Andrology 2016; 4:152-9. [DOI: 10.1111/andr.12136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/11/2015] [Accepted: 10/23/2015] [Indexed: 12/15/2022]
Affiliation(s)
| | - M. Punab
- Andrology Unit; Tartu University Hospital; Tartu Estonia
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Medrano M, Maiz E, Maldonado-Martín S, Arenaza L, Rodríguez-Vigil B, Ortega F, Ruiz J, Larrarte E, Diez-López I, Sarasúa-Miranda A, Tobalina I, Barrenechea L, Pérez-Asenjo J, Kannengiesser S, Manhães-Savio A, Echaniz O, Labayen I. The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study. Contemp Clin Trials 2015; 45:346-355. [DOI: 10.1016/j.cct.2015.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 02/07/2023]
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