Department of Pediatrics, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
PLoS One. 2012;7(10):e48645. doi: 10.1371/journal.pone.0048645. Epub 2012 Oct 31.
The iron status in human body and its association with liver function in adolescents was rarely studied. The objective was to investigate the association among the levels of serum ferritin, uric acid and alanine aminotransferase (ALT) in adolescents.
A total of 2090 adolescents negative for hepatitis B surface antigen from one junior high school (786, 12-13 years), three senior high schools (973, 15-16 years) and one college (331, 18-19 years) participated in this survey. Anthropometric and biochemical measurements, including complete blood count, ALT, serum ferritin and uric acid were performed. An ALT>42 U/L was defined as elevated, a ferritin level >200 µg/L was defined as hyperferritinemia. A uric acid level >460 µmol/L in males and >340 µmol/L in females was defined as hyperuricemia. The chi-squared test, linear regression and multivariate logistic regression were used for the data analysis. Elevated ALT levels were detected in 76 (3.6%) students and were more prevalent in males than females (6.4% vs. 2.0%, p<0.001). The univariate analysis found gender, age group, body mass index, ferritin level, uric acid level and white blood cell count all to be significantly associated with elevated ALT. Linear regression showed a positive correlation among log(ferritin), uric acid level and ALT level. Elevated ALT occurred more frequently at ferritin level >100 µg/L. The logistic regression analysis found that body mass index, hyperferritinemia and hyperuricemia were significant factors associated with the ALT elevation, but gender, age, and white blood cell count were not.
Hyperferritinemia and hyperuricemia are two independently significant factors associated with ALT elevation among obese adolescents. More studies are needed to corroborate any hypothesis related to these phenomena.
人体铁状态及其与青少年肝功能的关系很少被研究。本研究旨在探讨青少年血清铁蛋白、尿酸和丙氨酸氨基转移酶（ALT）水平之间的关系。
共 2090 名来自一所初中（786 人，12-13 岁）、三所高中（973 人，15-16 岁）和一所大学（331 人，18-19 岁）的乙型肝炎表面抗原阴性青少年参与了这项调查。进行了人体测量学和生化测量，包括全血细胞计数、ALT、血清铁蛋白和尿酸。将 ALT>42 U/L 定义为升高，铁蛋白水平>200 µg/L 定义为高铁蛋白血症。男性尿酸水平>460 µmol/L 和女性>340 µmol/L 定义为高尿酸血症。采用卡方检验、线性回归和多因素 logistic 回归进行数据分析。76 名（3.6%）学生存在 ALT 升高，且男性明显高于女性（6.4%比 2.0%，p<0.001）。单因素分析发现，性别、年龄组、体重指数、铁蛋白水平、尿酸水平和白细胞计数均与 ALT 升高显著相关。线性回归显示 log(铁蛋白)、尿酸水平和 ALT 水平之间呈正相关。铁蛋白水平>100 µg/L 时，ALT 升高更为常见。logistic 回归分析发现，体重指数、高铁蛋白血症和高尿酸血症是与 ALT 升高相关的显著因素，但性别、年龄和白细胞计数不是。
肥胖青少年的高铁蛋白血症和高尿酸血症是与 ALT 升高相关的两个独立显著因素。需要进一步研究来证实与这些现象相关的任何假设。
