Graduate Program in Health Promotion, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil.
Department of Health Sciences, Graduate Program in Health Promotion, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil.
Pediatr Res. 2020 Dec;88(6):945-949. doi: 10.1038/s41390-020-0832-7. Epub 2020 Mar 14.
The associations of renal, hepatic, and hematologic markers with metabolic risk (MR) have already been shown in adolescents. However, it is still controversial which marker best predicts metabolic changes in youth. The aim of this study was to verify the association of MR with alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid, and hemoglobin (Hb) in adolescents.
We evaluated 1713 Brazilian adolescents aged 10 to 17 years. MR was calculated using a continuous metabolic risk score, including the sum of Z-scores of waist circumference, systolic blood pressure, fasting glucose, high-density lipoproteins, triglycerides, and cardiorespiratory fitness. Cutoff points were set for MR prediction for five metabolic components (ALT, AST, AST/ALT ratio, uric acid, and Hb).
MR was strongly associated with increased uric acid (odds ratio [OR]: 2.50; 95% confidence interval [CI]: 1.74-3.59), ALT (OR: 2.64; 95% CI: 1.63-4.27), and AST levels (OR: 2.53; 95% CI: 1.24-5.18). Uric acid was shown to be the best predictor for MR (sensitivity: 55.79%; specificity: 61.35%; area under the curve: 0.616).
Elevated hepatic, renal, and hematological markers were associated with MR in adolescents, especially ALT, AST, and uric acid levels.
Elevated hepatic, renal, and hematological markers were associated with metabolic risk in adolescents, especially ALT, AST, and uric acid levels. It is still controversial which marker best predicts metabolic changes in adolescents. In addition, association of Hb with metabolic risk is under-studied in this population. It is important to further investigate the relationship between elevated Hb and hepatic markers, since there are key aspects not addressed yet. Our results highlight the importance of creating public health policies aimed to child and adolescent population, to prevention of metabolic disorders from an early age.
已有研究表明，在青少年中，肾脏、肝脏和血液标志物与代谢风险（MR）之间存在关联。然而，哪种标志物最能预测年轻人的代谢变化仍存在争议。本研究旨在验证丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、尿酸和血红蛋白（Hb）与青少年代谢风险的相关性。
我们评估了 1713 名 10 至 17 岁的巴西青少年。MR 采用代谢风险评分的连续测量来计算，包括腰围、收缩压、空腹血糖、高密度脂蛋白、甘油三酯和心肺适能 Z 分数的总和。设定了五个代谢成分（ALT、AST、AST/ALT 比值、尿酸和 Hb）的 MR 预测切点。
MR 与尿酸（比值比 [OR]：2.50；95%置信区间 [CI]：1.74-3.59）、ALT（OR：2.64；95% CI：1.63-4.27）和 AST 水平（OR：2.53；95% CI：1.24-5.18）显著相关。尿酸是预测 MR 的最佳标志物（灵敏度：55.79%；特异性：61.35%；曲线下面积：0.616）。
在青少年中，升高的肝、肾和血液标志物与 MR 相关，特别是 ALT、AST 和尿酸水平。
在青少年中，升高的肝、肾和血液标志物与代谢风险相关，特别是 ALT、AST 和尿酸水平。哪种标志物最能预测青少年的代谢变化仍存在争议。此外，Hb 与代谢风险的相关性在该人群中研究较少。进一步研究 Hb 升高与肝标志物之间的关系很重要，因为仍有一些关键方面尚未涉及。我们的研究结果强调了制定针对儿童和青少年人群的公共卫生政策的重要性，以从早期预防代谢紊乱。
