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Pediatr Obes. 2015 Oct;10(5):361-70. doi: 10.1111/ijpo.273. Epub 2014 Dec 17.

Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study.

Author information

1
Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria, Spain.
2
PROFITH 'PROmoting FITness and Health through Physical Activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
3
Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden.
4
Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
5
Department of Pediatrics, Faculty of Medicine, University of Zaragoza, Health Research Institute of Aragon (IIS Aragón), Aragon, Spain.
6
Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.
7
Department of Nutrition and Food Science, University of Bonn, Bonn, Germany.
8
INSERM, U744, Institut Pasteur de Lille, UDSL, Lille, France.
9
Immunonutrition Research Group, Department of Metabolism and Nutrition, Spanish Council for Scientific Research (CSIC), Madrid, Spain.
10
Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Vienna, Austria.
11
University of Crete School of Medicine, Greece.
12
Department of Pediatrics, University of Pecs, Pecs, Hungary.
13
Department of Public Health, School of Medicine, Ghent University, Ghent, Belgium.
14
Inserm U995, Pediatric Department, Lille University Hospital and University Lille 2, France.
15
Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
16
Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

Abstract

OBJECTIVES:

This study aimed to explore the associations of liver biomarkers with cardiometabolic risk factors and their clustering, and to provide reference values (percentiles) and cut-off points for liver biomarkers associated with high cardiometabolic risk in European adolescents.

METHODS:

Alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase to ALT ratio (AST/ALT), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin were measured in 1084 adolescents. We computed a continuous cardiometabolic risk score and defined the high cardiometabolic risk.

RESULTS:

Higher ALT and GGT and lower AST/ALT were associated with adiposity and with the number of adverse cardiometabolic risk factors (Ps < 0.05). Higher GGT and lower AST/ALT were associated with higher cardiometabolic risk score (Ps < 0.001) in males and females, and ALT only in males (Ps < 0.001). Gender- and age-specific percentiles for liver biomarkers were provided. Receiver operating characteristic analyses showed a significant discriminatory accuracy of AST/ALT in identifying the low/high cardiometabolic risk (Ps < 0.01) and thresholds were provided.

CONCLUSIONS:

Higher GGT and lower AST/ALT are associated with higher cardiometabolic risk factors and their clustering in male and female European adolescents, whereas the associations of ALT were gender dependent. Our results suggest the usefulness of AST/ALT as a screening test in the assessment of adolescents with high cardiometabolic risk and provide gender- and age-specific thresholds that might be of clinical interest.

KEYWORDS:

Liver; adolescents; cardiometabolic risk factors; obesity

PMID:
25515703
DOI:
10.1111/ijpo.273
[Indexed for MEDLINE]

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