Arancibia Gabriel, García Hernán, Jaime Francisca, Bancalari Rodrigo, Harris Paul R
Unidad de Gastroenterología y Nutrición Pediátrica, Pontificia Universidad Católica de Chile, Chile.
Rev Med Chil. 2012 Jul;140(7):896-901. doi: 10.4067/S0034-98872012000700010.
There is a high prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among pediatric patients. The identification of clinical predictors of these conditions would allow a timely treatment.
To evaluate the relationship between serum alanine aminotransferase levels and parameters of metabolic syndrome in asymptomatic school students without hepatic illness.
A randomized sample of 175 children aged between 9 and 14 years (54% females) was selected, from a database of 3010 students living in Santiago, Chile. Weight, height, abdominal circumference, systolic and diastolic blood pressure were measured. A fasting blood sample was obtained to measure glucose, total cholesterol, HDL, LDL-cholesterol, triglycerides, alanine aminotransferase (ALT) and insulin levels.
Forty percent of participants were obese, 17% had metabolic syndrome and 13.1% had abnormal ALT levels. Compared with children with normal ALT levels, the latter had significantly higher waist obesity, body mass index, systolic and diastolic blood pressure and triglycerides. However on multivariate analysis, only waist obesity was independently associated with abnormal ALT levels (adjusted odds ratio 3.93, 95% confidence intervals 1.44-10.78, p = 0.008).
Only waist obesity was independently associated with abnormal ALT levels in this sample of children.
儿童患者中非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的患病率很高。确定这些疾病的临床预测指标将有助于及时治疗。
评估无症状且无肝脏疾病的在校学生血清丙氨酸氨基转移酶水平与代谢综合征参数之间的关系。
从智利圣地亚哥3010名学生的数据库中随机抽取175名9至14岁的儿童（54%为女性）。测量体重、身高、腹围、收缩压和舒张压。采集空腹血样以测量血糖、总胆固醇、高密度脂蛋白、低密度脂蛋白胆固醇、甘油三酯、丙氨酸氨基转移酶（ALT）和胰岛素水平。
40%的参与者肥胖，17%患有代谢综合征，13.1%的ALT水平异常。与ALT水平正常的儿童相比，后者的腰围肥胖、体重指数、收缩压和舒张压以及甘油三酯显著更高。然而，多变量分析显示，只有腰围肥胖与ALT水平异常独立相关（调整后的优势比为3.93，95%置信区间为1.44 - 10.78，p = 0.008）。
在这个儿童样本中，只有腰围肥胖与ALT水平异常独立相关。
