Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity

Abstract

SummaryBackgroundLimited research on alanine aminotransferase (ALT) screening for metabolic dysfunction‐associated steatotic liver disease (MASLD) among US Asian/Pacific Islander (PI) children necessitates investigation in this heterogeneous population.ObjectiveExamine ALT elevation among Asian/PI children with overweight or obesity.MethodsElevated ALT prevalence (clinical threshold) and association with body mass index ≥85th percentile were compared among 18 402 Asian/PI and 25 376 non‐Hispanic White (NHW) children aged 9–17 years using logistic regression.ResultsALT elevation was more prevalent among Asian/PI (vs. NHW) males with overweight (4.0% vs. 2.7%), moderate (7.8% vs. 5.3%) and severe obesity (16.6% vs. 11.5%), and females with moderate (5.1% vs. 3.0%) and severe obesity (10.2% vs. 5.2%). Adjusted odds of elevated ALT were 1.6‐fold and ~2‐fold higher for Asian/PI (vs. NHW) males and females (with obesity), respectively. Filipino, Chinese and Southeast Asian males had 1.7–2.1‐fold higher odds, but Native Hawaiian/PI (NHPI) and South Asian males did not significantly differ (vs. NHW). Filipina and Chinese females with obesity had >2‐fold higher odds, Southeast and South Asian females did not differ and NHPI findings were mixed (vs. NHW).ConclusionHigh elevated ALT prevalence among Asian/PI children with overweight and obesity emphasizes the need for MASLD risk assessment and examination of ethnic subgroups.