Kelishadi Roya, Abtahi Seyed-Hossein, Qorbani Mostafa, Heshmat Ramin, Esmaeil Motlagh Mohammad, Taslimi Mahnaz, Aminaee Tahereh, Ardalan Gelayol, Poursafa Parinaz, Moin Payam
Department of Pediatrics, Child Growth and Development Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Hepat Mon. 2012 Nov;12(11):e7711. doi: 10.5812/hepatmon.7711. Epub 2012 Nov 30.
By the current global obesogenic environment, non-alcoholic fatty liver disease is becoming an important health problem in the pediatric age group.
This study aimed to determine the first age-and gender-specific percentiles and upper limit normal limit (ULN) of alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) among a nationally-representative sample of children and adolescents in the Middle East and North Africa (MENA). The second objective was to determine the linear association of obesity indexes and age with serum ALT and AST levels.
This nationwide study was conducted among a representative sample of 4078 students aged 10-18 years, who were selected by multistage random cluster sampling from 27 provinces of Iran. ALT and AST were measured on fresh sera. Body mass index (BMI) was calculated as an index of generalized obesity, and waist- to- height ratio (WHtR) as an index of abdominal obesity. The age- and gender-specific percentiles of ALT and AST were constructed, and the 95th percentile of each enzyme was considered as the ULN. Gender-specific linear regression analysis was employed to examine the association of BMI or WHtR with the levels of ALT and AST.
Data of ALT and AST were available for 4078 (2038 girls) and 4150 (2061 girls),respectively. Participants had a mean (SD) age of 14.71 (2.41).The ULN of ALT for boys, girls,and the total individuals were 36.00; 38.00; and, 37.00 U/L, respectively. In both genders, ALT and AST had linear association with age. The association with BMI was significant for ALT in both genders and for AST only in boys, the association of ALT with WHtR was significant in both genders; the corresponding figures were not significant for AST.
The findings of the current study confirmed the current ULN value of 40 U/L commonly used for the pediatric age group. The linear association of indexes for generalized and abdominal obesity with ALT underscores the importance of timely prevention and control of childhood obesity.
在当前全球致肥胖环境下，非酒精性脂肪性肝病正成为儿童年龄组中的一个重要健康问题。
本研究旨在确定中东和北非（MENA）地区具有全国代表性的儿童和青少年样本中丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）的首个年龄和性别特异性百分位数以及正常上限（ULN）。第二个目的是确定肥胖指数和年龄与血清ALT和AST水平的线性关联。
这项全国性研究在4078名10至18岁学生的代表性样本中进行，这些学生通过多阶段随机整群抽样从伊朗的27个省份中选取。ALT和AST在新鲜血清上进行测量。计算体重指数（BMI）作为全身性肥胖的指标，计算腰高比（WHtR）作为腹部肥胖的指标。构建ALT和AST的年龄和性别特异性百分位数，并将每种酶的第95百分位数视为ULN。采用性别特异性线性回归分析来检验BMI或WHtR与ALT和AST水平的关联。
分别有4078名（2038名女孩）和4150名（2061名女孩）的ALT和AST数据可用。参与者的平均（标准差）年龄为14.71（2.41）。男孩、女孩和总体人群的ALT的ULN分别为36.00；38.00；和37.00 U/L。在两种性别中，ALT和AST与年龄均呈线性关联。BMI与ALT在两种性别中均显著相关，与AST仅在男孩中显著相关，ALT与WHtR在两种性别中均显著相关；AST的相应数据不显著。
本研究结果证实了目前常用于儿童年龄组的40 U/L的ULN值。全身性和腹部肥胖指标与ALT的线性关联强调了及时预防和控制儿童肥胖的重要性。
