Pediatric Gastroenterology, Hepatology & Nutrition
- Volume 6 Issue 2
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- Pages.174-182
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- 2003
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- 2234-8646(pISSN)
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- 2234-8840(eISSN)
The Clinical Usefulness of Serum Aminotransferase Activities for Predicting Fatty Liver in Obese Children
비만아에서 지방간의 예측 인자로서 혈청 Aminotransferase의 임상적 유용성
- Lim, Seon-Woong (Department of Pediatrics, Presbyterian Medical Center) ;
- Jeon, Myeong-Won (Department of Pediatrics, Presbyterian Medical Center) ;
- Park, Sin-Ae (Department of Pediatrics, Presbyterian Medical Center) ;
- Choi, Kyeong-Dan (Department of Pediatrics, Presbyterian Medical Center)
- Received : 2003.09.01
- Accepted : 2003.09.13
- Published : 2003.09.30
Abstract
Purpose: Non-alcoholic fatty liver disease (NAFLD) has been recognized as an important childhood liver disease, especially where the prevalence of childhood obesity is increasing. The purpose of this study is to clarify the usefulness of elevated serum aminotransferase activities and their ratio for predicting the presence of fatty liver and its severity in obese children. Methods: Forty-four children (M/F 29/15, age 4 to 16 years) with obesity (weight excess>20%) were analyzed retrospectively with medical records based on degree of obesity, bioelectrical impedence, serum aminotransferase activities, lipid profiles and ultrasonography. Results: 1) Ultrasonography was carried out in 34 cases. Elevated serum ALT was found in 89.7% (26/29) of the patients diagnosed as fatty liver by ultrasonography and decreased AST/ALT ratio (<1) was found in 96.6% (28/29). There was a strong correlation between elevated serum ALT (>45 IU/L) or decreased AST/ALT ratio (<1) and the fatty liver in obese children (p<0.05). 2) There was no significant correlation between the serum ALT or AST/ALT ratio and the degree of fatty liver (p>0.05). 3) There was a significant correlation between total cholesterol, triglyceride and fatty liver (p<0.05). Conclusion: Serum ALT activity and AST/ALT ratio were useful to predict the presence of fatty liver diagnosed by ultrasonography in obese children, whereas they were not useful to predict the degree of fatty liver. Therefore, to prevent fatty liver progressing to advanced liver disease, it is necessary to manage and monitor the obese children continuously, especially those who have predicting factors of fatty liver.
목 적: 지방간은 여러 비만 합병증 중의 하나로 최근 소아 비만이 늘어나면서 그 유병률이 증가하고 있다. 소아에서 지방간은 대부분 양성 경과를 보이지만 일부에서는 지방 섬유화와 지방 간경변으로 진행된 사례도 보고되고 있어서 지방간의 조기 진단과 관리의 필요성이 증가하고 있다. 저자들은 비만아에서 간 효소치의 상승으로 지방간의 동반 유무 및 그 정도를 예측할 수 있는지 알아보고, 비만아에서 지방간을 예측할 수 있는 다른 예측인자에 대해 알아보고자 하였다. 방 법: 2002년 3월부터 2003년 7월까지 예수병원 소아과 비만 클리닉에 내원한 4세부터 16세사이의 환아 중 비만도가 20% 이상인 44례의 환아를 대상으로 하였다. 대상 환아의 비만도, 체질량지수를 측정하였고 체성분 분석, 간 효소치, 혈청 지질 검사 및 복부 초음파 검사를 시행하였다. 결 과: 1) 대상 환아의 평균 연령은