Risk Factors for Non-Alcoholic Fatty Liver Disease in Obese Children

Engiz, Ozlem; Berberoğlu, Merih; Şıklar, Zeynep; Öçal, Gönül

doi:10.1159/000224343

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…Habitually, in children, NAFLD is asymptomatic, and increased serum of aminotransferase is a predictor of NAFLD [22,62]; however, normal serum levels of these liver enzymes do not exclude the existence of the disease [19,61]. It is reported that hyperinsulinemia plays a significant role in the genesis of fatty liver, and hepatic insulin resistance may be the underlying pathogenetic factor linking obesity and NAFDL [19,63,64,65,66].…”

Section: Discussionmentioning

confidence: 99%

Early-Onset Metabolic Syndrome in Prepubertal Obese Children and the Possible Role of Alanine Aminotransferase as Marker of Metabolic Syndrome

et al. 2011

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Introduction: Obesity is often associated with increased serum alanine aminotransferase (ALT), and elevation of ALT is a marker of non-alcoholic fatty liver disease which is caused in part by insulin resistance, the essential characteristic of metabolic syndrome (MS). We evaluated the prevalence of MS in prepubertal obese children and the usefulness of ALT as an MS marker. Patients: 120 obese children (6.3 ± 1.6 years old) and 50 normal-weight controls (5.3 ± 2.0 years old) were included. Patients were classified as having MS if they met ≧3 of the following criteria: body mass index >97th percentile, triglycerides >95th percentile, high-density lipoprotein cholesterol <5th percentile, systolic (SBP) and/or diastolic (DBP) blood pressure >95th percentile, fasting blood glucose 100 mg/dl and/or impaired insulin sensitivity with homeostasis model assessment for insulin resistance >97.5th percentile. ALT levels were also evaluated. Results: MS occurred in 16.6% of obese patients. Significant differences were present in body mass index (p < 0.001), SBP (p = 0.002) and DBP (p < 0.001) between non-MS and MS obese patients; laboratory data, except total cholesterol, were significantly different in the two groups. The strongest association with MS (as evaluated by the c-statistic) was found for insulin and homeostasis model assessment for insulin resistance (c = 0.92 and 0.91, respectively); also, DBP and SBP showed good discrimination ability (c = 0.73 and 0.72, respectively). ALT levels in the MS group were higher than in the non-MS group (p = 0.02) and associated with MS (p = 0.001; c = 0.69). Conclusion: MS is a consequence of obesity already in very young children. Also, pathological serum ALT levels were significantly correlated with MS and might be considered a marker for defining MS, though confirmation in a longitudinal study is called for.

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Section: Discussionmentioning

confidence: 99%

Early-Onset Metabolic Syndrome in Prepubertal Obese Children and the Possible Role of Alanine Aminotransferase as Marker of Metabolic Syndrome

et al. 2011

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“…Hypertriglyceridemia is another biochemical marker frequently reported in obese children with NAFLD [ 86 ], with a positive correlation with an increased ALT [ 87 , 88 ]. In children’s atherogenic lipid profile, this correlates with the severity of liver injury [ 89 ].…”

Section: Childhood Obesity and Non-alcoholic Fatty Liver Diseasementioning

confidence: 99%

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.

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“…A more recent study of more than 600 obese children revealed 16% of the subjects had ALT levels >40 U/L . In studies of obese children and adolescents with elevated ALT, ALT has been shown to correlate with gender (higher in boys than girls), ethnicity/race (highest in Mexican Americans, lowest in African‐Americans), BMI, waist circumference, quantitative insulin sensitivity check index (QUICKI), CRP, fasting glucose and insulin levels, and TG . The most recent practice guidelines from the Endocrine Society recommend screening obese and overweight children for increased ALT (abnormal defined as > 2 SD above the mean for the laboratory) as a marker of NAFLD .…”

Section: Introductionmentioning

confidence: 99%

“…13 In studies of obese children and adolescents with elevated ALT, ALT has been shown to correlate with gender (higher in boys than girls), ethnicity/race (highest in Mexican Americans, lowest in African-Americans), BMI, waist circumference, quantitative insulin sensitivity check index (QUICKI), CRP, fasting glucose and insulin levels, and TG. 9,[14][15][16][17][18] The most recent practice guidelines from the Endocrine Society recommend screening obese and overweight children for increased ALT (abnormal defined as > 2 SD above the mean for the laboratory) as a marker of NAFLD. 19 While studies of adults have shown that ALT even within the normal range is associated with the risk of diabetes or the metabolic syndrome, this has not been previously studied in children.…”

Section: Introductionmentioning

confidence: 99%

Alanine transferase: An independent indicator of adiposity related comorbidity risk in youth

Klein

Iazzettii

Speiser

et al. 2014

Journal of Diabetes

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Risk Factors for Non-Alcoholic Fatty Liver Disease in Obese Children

Cited by 5 publications

References 6 publications

Early-Onset Metabolic Syndrome in Prepubertal Obese Children and the Possible Role of Alanine Aminotransferase as Marker of Metabolic Syndrome

Early-Onset Metabolic Syndrome in Prepubertal Obese Children and the Possible Role of Alanine Aminotransferase as Marker of Metabolic Syndrome

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Alanine transferase: An independent indicator of adiposity related comorbidity risk in youth

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