Clinical significance of serum alanine aminotransferase and lifestyle intervention in children with nonalcoholic fatty liver disease

Abstract

PurposeThis study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD.MethodsThe clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of patients with NAFLD were also compared based on the status of ALT levels after lifestyle intervention.ResultsPatients with elevated ALT had significantly higher body mass index (BMI) scores than those with normal ALT (P<0.05). Of all the patients with elevated ALT, 89% exhibited moderate or severe degree of fatty change in the liver on ultrasonographic examination, whereas most patients with normal ALT exhibited mild or moderate degree changes. Liver biopsy was performed in 15 children with elevated ALT and all showed mild histological changes. Of all patients with elevated ALT, 49% achieved normal ALT levels after lifestyle intervention. Those with more severe histological changes tended to have continuously increasing ALT levels. There was no correlation between the normalization of posttreatment ALT level and BMI, as well as ultrasonographic findings at diagnosis.ConclusionALT elevation in NAFLD is highly associated with higher BMI scores and more severe degree of fatty changes on ultrasonographic examination. Lifestyle intervention can significantly improve ALT in children with NAFLD. The degree of histologic changes appears to be a predictor of the treatment response to NAFLD.

Buchholzia coriacea seed (wonderful kolanut) alleviates insulin resistance, steatosis, inflammation and oxidative stress in high fat diet model of fatty liver disease

“…In this study, there was significant increase in plasma activities of ALT, AST, and ALP in HFD fed mice compared with control. These enzyme are established biomarkers of hepatocellular damage, and their plasma activities have been widely used in assessing the progression of NAFLD (Chang et al., 2007; Khosravi et al., 2018; Kwon et al., 2016). Hepatocellular damage observed in the HFD fed mice may be related to oxidative stress and other related hepatotoxic events.…”

“…Prolonged cellular oxidative stresses can cause membrane lipid peroxidation and cellular damage, leading to cell death by necrosis and apoptosis (de Freitas Carvalho et al., 2019; Masarone et al., 2018). Several studies have reported increase in plasma activities of ALT, AST, and ALP in clinical NAFLD and animal models (Chang et al., 2007; Khosravi et al., 2018; Kwon et al., 2016). HEBCS administration alongside HFD significantly alleviates the elevated plasma activities of ALT, AST, and ALP in mice.…”

Aerobic training performed at ventilatory threshold improves liver enzymes and lipid profile related to non-alcoholic fatty liver disease in adolescents with obesity

“…The prevalence of NAFLD is up to 90% in adolescents with obesity (de Armas et al, 2015). Studies reveal that even small weight gain is related to the development and remission of NAFLD, regardless of body mass index (BMI) (Kim et al, 2009; Kwon et al, 2016). It has also been demonstrated that insulin resistance (IR), even in normal-weight individuals (Erdmann et al, 2008), and moderate visceral fat accumulation (Orr et al, 2008) increases circulating levels of free fatty acids (FFA) (Ruderman et al, 1969).…”