Prevalence and predictors of alanine aminotransferase elevation among normal weight, overweight and obese youth in Mexico

Abstract

Obesity and certain metabolic risk factors are important predictors for elevated ALT. Screening for ALT levels in obese youth could help to identify those at risk and reduce the possibility of future liver diseases.

Prevalence of Non-alcoholic Fatty Liver Disease and Steatohepatitis Risk Factors in Patients Undergoing Bariatric Surgery

“…Increases in serum ALT levels signal the presence of liver damage in obese patients [31,24], and several studies have linked increased serum levels of liver transaminases to steatohepatitis [29,[31][32][33]. In our study, although serum levels of ALT and AST were not significantly elevated, progressively higher ALT levels were detected according to the deterioration of the histological pattern.…”

Diagnostic performance of anthropometric measurements in detecting elevated serum alanine aminotransferase: a school-based screening of 7271 Shenzhen adolescents

“…Consistent findings that the proportion of elevated ALT greatly increased with increasing degree of obesity (e.g. the percentile or z-score of BMI), and higher proportion among overweight or obese adolescents than normal-weight ones were shown in previous studies and our research, regardless of the use of diagnostic criteria for an elevated ALT activity 7,13,18,32 . Based on the thresholds of ALT activity (40 U/L for boys and girls), nearly 6.6% of the Mexican youths (9.8% of boys and 3.8% of girls) For BMI, several studies had pointed out that BMI was able to determine the presence of elevated ALT among adults, although the accuracy was not very high in absolute term -the AUC (95% CI) was 0.658 (0.633-0.683) for men and 0.651 (0.616-0.685) for women in the rural areas of China 14 and 0.64 (0.60-0.68) for Italian general population 19 .…”

“…For the most commonly use of definitions among adolescents, an activity of elevated serum ALT was defined as > 30 U/L for boys and > 19 U/L for girls (diagnostic criterion I) 2,3,8,28 . Main analysis was undertaken using these sex-specific cut-offs, and a secondary analysis for the sake of comparison was also reported, defining with higher thresholds (> 40 U/L for both boys and girls; diagnostic criterion II) that have been proposed in previous observational literatures 7,13,29 to explore whether higher thresholds led to the same or different results.…”

“…The elevation of ALT has also been recorded by published evidence to be strongly linked to, or to predict, the developing of type 2 diabetes mellitus, insulin resistance, and cardiovascular diseases (e.g. atherogenesis and coronary heart disease) 2, 3, 5−11 . Screening for the concentration of serum ALT and verifying an elevated ALT activity could assist in determining individuals at risk for the above chronic conditions and reducing the possibility of future liver diseases 12,13 . However, the measurement of ALT levels requires blood collection, which is invasive and could be impractical in large-scale investigations.…”

“…had elevated ALT levels by using the baseline data from 1262 participants of 8-19 years in the Mexican Health Worker Cohort Study (MHWCS); elevated ALT concentration was also observed in 2.7% of normal-BMI, 14.2% of overweight, and 28.9% of the obese children and adolescents13 .According to the same thresholds (i.e. criterion II), the percentage of elevated ALT among Shenzhen adolescents of 9 − 17 years was 0.89% for normal-weight, 4.96% for overweight, and 20.58% for obese participants.…”