Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
Metab Syndr Relat Disord. 2012 Oct;10(5):337-43. doi: 10.1089/met.2012.0015. Epub 2012 Jun 25.
We studied the associations of clustering of metabolic risk factors with plasma levels of alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) in healthy prepubertal children.
The subjects were a representative population sample of 492 children 6-8 years of age. We assessed body fat percentage (dual-energy X-ray absorptiometry), body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, ALT, GGT, and high-sensitivity C-reactive protein (hsCRP) and calculated a continuous metabolic syndrome score variable. We also used factor analysis to examine whether high-normal liver enzymes are a feature of metabolic syndrome among children.
Children with overweight or obesity, defined by International Obesity Task Force (IOTF) criteria, had a 2.1-times higher risk of having ALT and a 4.5-times higher risk of having GGT in the highest fifth of its distribution than normal weight children. Children in the highest sex-specific third of metabolic syndrome score, body fat percentage, waist circumference, and insulin had a two to three times higher risk of being in the highest fifth of ALT and GGT. Moreover, children in the highest third of glucose and hsCRP had a 2.5-fold risk of being in the highest fifth of GGT. First-order factor analysis yielded three factors; the first included insulin, glucose, and triglycerides; the second waist circumference, insulin, GGT, and hsCRP; and the third HDL-C, triglycerides, waist circumference, and insulin. Second-order factor analysis yielded a single metabolic syndrome factor, explaining 64.1% of the variance.
Clustering of metabolic risk factors, particularly excess body fat, is associated with high-normal levels of ALT and GGT in prepubertal children. High-normal levels of liver enzymes, especially GGT, and systemic low-grade inflammation could be considered features of metabolic syndrome among children. Subtle changes in liver function may play an important role in the pathogenesis of metabolic syndrome beginning in childhood.
我们研究了代谢风险因素的聚类与健康青春期前儿童血浆丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）水平之间的关系。
研究对象为 492 名 6-8 岁的代表性人群样本。我们评估了体脂肪百分比（双能 X 射线吸收法）、体重指数、腰围、收缩压和舒张压、血糖、胰岛素、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯、ALT、GGT 和高敏 C 反应蛋白（hsCRP），并计算了一个连续的代谢综合征评分变量。我们还使用因子分析来检验高正常肝酶是否是儿童代谢综合征的一个特征。
根据国际肥胖工作组（IOTF）标准定义的超重或肥胖儿童，其 ALT 分布最高五分位的风险比正常体重儿童高 2.1 倍，GGT 分布最高五分位的风险比正常体重儿童高 4.5 倍。代谢综合征评分、体脂肪百分比、腰围和胰岛素最高性别特异性三分位的儿童，其 ALT 和 GGT 分布最高五分位的风险高 2-3 倍。此外，血糖和 hsCRP 最高三分位的儿童，GGT 分布最高五分位的风险高 2.5 倍。一阶因子分析得到三个因子；第一个因子包括胰岛素、血糖和甘油三酯；第二个因子包括腰围、胰岛素、GGT 和 hsCRP；第三个因子包括 HDL-C、甘油三酯、腰围和胰岛素。二阶因子分析得到一个单一的代谢综合征因子，解释了 64.1%的方差。
代谢风险因素的聚类，特别是体脂肪过多，与青春期前儿童的 ALT 和 GGT 高正常水平相关。高正常水平的肝酶，尤其是 GGT，以及全身性低度炎症，可被视为儿童代谢综合征的特征。肝功能的细微变化可能在儿童期开始的代谢综合征发病机制中发挥重要作用。
