Comparison of serum aminotranferases in overweight and obese children

Keywords: Serum aminotransferases, body mass index, obese children

Abstract

Background Obesity has become a global issue. Non-alcoholic fatty liver disease is a metabolic complication of obesity, and indicated by elevated serum aminotransferases.

Objective To compare serum aminotransferase levels in overweight and obese children.

Methods This cross-sectional study was conducted from August to October 2015. A total of 82 subjects aged 6-10 years met the study criteria. Blood specimens and data concerning lifestyle and family history using questionnaires were collected. Subjects were divided into three groups based on BMI: overweight, obese, and severely obese. Comparisons of serum aminotransferase levels were analyzed by Kruskal-Wallis and post hoc tests, with P values < 0.05.

Results The median serum alanine aminotransferase (ALT) levels in overweight, obese, and severely obese subjects were 14 (IQR 6-42) U/L, 15 (IQR 11-44) U/L, and 23 (IQR 9-59) U/L, respectively (P=0.031). The median serum aspartate aminotransferase (AST) levels in overweight, obese, and severely obese subjects were 22 (IQR 17-36) U/L, 22 (IQR 16-32) U/L, and 24 (IQR 15-41) U/L, respectively (P=0.049). Post hoc analysis revealed that median serum ALT levels were significantly higher in the severely obese group than in the overweight group [-8.982 (95% CI -14.77 to -3.20; P=0.003)], as well as in the obese group [-5.297 (95% CI -10.58 to -0.02; P=0.049)]. In addition, the median serum AST level was significantly higher in the severely obese group than in the obese group [-2.667(95% CI -5.27 to -0.07; P= 0.044)].

Conclusion Median serum ALT and AST levels are significantly higher in severely obese children than in obese and overweight children. 

Author Biography

I Gusti Lanang Sidiartha
Departement of Child Health, Medical Faculty,  Udayana University

References

1. de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010;92:1257-64.
2. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia.Riskesdas. Laporan Nasional 2013. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013. p1-20
3. Adhianto G, Soetjiningsih. Prevalence and risk factors of overweight and obesity in adolescents. Paediatr Indones. 2002;42:206-11.
4. Ratna MD, Sidiartha IGL. Prevalensi dan faktor risiko obesitas anak sekolah dasar di daerah urban dan rural. Medicina. 2013;44:15-21.
5. Damayanti RS, Lanny CG, Aryono H, Endang DL, Lanang SIG, Maria M. Rekomendasi Ikatan Dokter Anak Indonesia: diagnosis, tata laksana dan pencegahan obesitas pada anak dan remaja. 1st ed. Jakarta: Ikatan Dokter Anak Indonesia; 2014. p. 1-14.
6. Fraser A, Longnecker MP, Lawler DA. Prevalence of elevated alanine aminotransferase (ALT) among US adolescents and associated factors: NHANES 1999-2004. Gastroenterology. 2007;133:1814–20.
7. Ahn MB, Bae WR, Han KD, Cho WK, Cho KS, Park SH, et al. Association between serum alanine aminotransferase level and obesity indices in Korean adolescents. Korean J Pediatr. 2015;58:165­71.
8. Tominaga K, Kurata JH, Chen YK, Fujimoto E, Miyagawa S, Abe I, Kusano Y. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci. 1995;40:2002–9.
9. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–93.
10. Engelmann G, Hoffmann GF, Grulich-Henn J, Teufel U. Alanine aminotransferase elevation in obese infants and children: a marker of early onset non alcoholic fatty liver disease. Hepat Mon. 2014;14:e14112.
11. Rodríguez G, Gallego S, Breidenassel C, Moreno LA, Gottrand F. Is liver transaminases assessment an appropriate tool for the screening of non-alcoholic fatty liver disease in at risk obese children and adolescents? Nutr Hosp. 2010;25:712-7.
12. Franzese A, Vajro P, Argenziano A, Puzziello A, Iannucci MP, Saviano MC, et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig Dis Sci. 1997;42:1428-32.
13. Lin YC, Chang PF, Yeh SJ, Liu K, Chen HC. Risk factors for liver steatosis in obese children and adolescents. Pediatr Neonatol. 2010;51:149-54.
14. Grotti Clemente AP, Molin Netto BD, Ganen Ad, Tock L, Arisa Caranti D, de Mello MT, et al. Cut-off values of visceral adiposity to predict NAFLD in Brazilian obese adolescents. J Nutr Metab. 2013;724781.
15. Park HS, Han JH, Choi KM, Kim SM. Relation between elevated serum alanine aminotransaminase and metabolic syndrome in Korean adolescents. Am J Clin Nutr. 2005;82:1046-51.
16. Xanthakos SA, Kohil R. Pediatric nonalcoholic fatty liver disease: prevalence, diagnosis, risk factor, and management. Clin Liver Dis. 2012;1:125-8.
Published
2017-01-16
How to Cite
1.
Shanti A, Sidiartha IG. Comparison of serum aminotranferases in overweight and obese children. PI [Internet]. 16Jan.2017 [cited 29Mar.2024];56(6):350-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/982
Received 2016-10-21
Accepted 2016-12-21
Published 2017-01-16