Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Association between serum alanine amino­transferase level and obesity indices in Korean adolescents

  • Ahn, Moon Bae (Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Bae, Woo Ri (Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Han, Kyung Do (Department of Biostatistics, The Catholic University of Korea College of Medicine) ;
  • Cho, Won Kyoung (Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Cho, Kyoung Soon (Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Park, So Hyun (Department of Pediatrics, St. Vincent Hospital, The Catholic University of Korea College of Medicine) ;
  • Jung, Min Ho (Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Suh, Byung Kyu (Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2014.07.17
  • 심사 : 2014.10.02
  • 발행 : 2015.05.10
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초록

Purpose: To analyze the correlation between serum alanine aminotransferase (ALT) and obesity indices including body mass index (BMI), body fat percentage (BFP), total fat mass (FM), truncal fat mass (TFM), waist circumference (WC), and waist-to-height ratio (WHtR) in Korean adolescents. Methods: This was a cross-sectional study based on data derived from the 2010-2011 Korean National Health and Nutrition Examination Surveys (KNHANES). Subjects were Korean adolescents aged 10-18 years (871 total; 475 boys and 396 girls) who participated in KNHANES. Results: In both sexes, BMI, FM, TFM, WC, and WHtR were higher when ALT levels were in the 4th quartile. In boys, there was a significant positive correlation between ALT level and BMI, BFP, FM, TFM, WC, and WHtR (r=0.55, P<0.0001 for BMI; r=0.52, P<0.0001 for BFP; r=0.58, P<0.0001 for FM; r=0.61, P<0.0001 for TFM; and r=0.56, P<0.0001 for WC; r=0.62, P<0.0001 for WHtR), and the correlation coefficient was higher than that in girls. Conclusion: Our results suggest a significant positive association between serum ALT level and obesity indices in male adolescents.

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참고문헌

  1. Park HW, Chung S. Body composition and obesity in Korean adolescents and its impact on diabetes mellitus. Korean J Obes 2013;22:137-44. https://doi.org/10.7570/kjo.2013.22.3.137
  2. Loomba R, Sirlin CB, Schwimmer JB, Lavine JE. Advances in pediatric nonalcoholic fatty liver disease. Hepatology 2009;50:1282-93. https://doi.org/10.1002/hep.23119
  3. Hwang SW, Kim DH, Kim HS. Prevalence of the nonalcoholic fatty liver disease in obese children. Korean J Pediatr 2005;48:13-20.
  4. Nho HN, Kim CR, Uhm JH, Kim JT, Jin SM, Seo JY, et al. The prevalence of obesity and metabolic abnormalities in Korean pediatric population. Korean J Pediatr Gastroenterol Nutr 2009;12:207-14.
  5. Yoo J, Lee S, Kim K, Yoo S, Sung E, Yim J. Relationship between insulin resistance and serum alanine aminotransferase as a surrogate of NAFLD (nonalcoholic fatty liver disease) in obese Korean children. Diabetes Res Clin Pract 2008;81:321-6. https://doi.org/10.1016/j.diabres.2008.05.006
  6. Park HS, Han JH, Choi KM, Kim SM. Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. Am J Clin Nutr 2005;82:1046-51. https://doi.org/10.1093/ajcn/82.5.1046
  7. Schwimmer JB, Dunn W, Norman GJ, Pardee PE, Middleton MS, Kerkar N, et al. SAFETY study: alanine aminotransferase cutoff values are set too high for reliable detection of pediatric chronic liver disease. Gastroenterology 2010;138:1357-64, 1364.e1-2. https://doi.org/10.1053/j.gastro.2009.12.052
  8. Ministry of Health & Welfare; Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: The fifth Korea National Health and Nutrition Examination Survey (KNHANES V-5). Cheongwon: Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention, 2011.
  9. Eknoyan G. Adolphe Quetelet (1796-1874): the average man and indices of obesity. Nephrol Dial Transplant 2008;23:47-51.
  10. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care 2004;27:1487-95. https://doi.org/10.2337/diacare.27.6.1487
  11. Burns CJ, Boswell JM, Olsen GW. Liver enzyme activity and body mass index. J Occup Environ Med 1996;38:1248-52. https://doi.org/10.1097/00043764-199612000-00010
  12. Robinson D, Whitehead TP. Effect of body mass and other factors on serum liver enzyme levels in men attending for well population screening. Ann Clin Biochem 1989;26(Pt 5):393-400. https://doi.org/10.1177/000456328902600503
  13. Liu Q, Bengmark S, Qu S. The role of hepatic fat accumulation in pathogenesis of non-alcoholic fatty liver disease (NAFLD). Lipids Health Dis 2010;9:42. https://doi.org/10.1186/1476-511X-9-42
  14. Leamy AK, Egnatchik RA, Young JD. Molecular mechanisms and the role of saturated fatty acids in the progression of non-alcoholic fatty liver disease. Prog Lipid Res 2013;52:165-74. https://doi.org/10.1016/j.plipres.2012.10.004
  15. Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev 2010;11:11-8. https://doi.org/10.1111/j.1467-789X.2009.00623.x
  16. Festi D, Colecchia A, Sacco T, Bondi M, Roda E, Marchesini G. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004;5:27-42. https://doi.org/10.1111/j.1467-789X.2004.00126.x
  17. Sweeting HN. Measurement and definitions of obesity in childhood and adolescence: a field guide for the uninitiated. Nutr J 2007;6:32. https://doi.org/10.1186/1475-2891-6-32
  18. Brann LS. Classifying preadolescent boys based on their weight status and percent body fat produces different groups. J Am Diet Assoc 2008;108:1018-22. https://doi.org/10.1016/j.jada.2008.03.007
  19. Choi JW. Association between elevated serum hepatic enzyme activity and total body fat in obese humans. Ann Clin Lab Sci 2003;33:257-64.
  20. Helba M, Binkovitz LA. Pediatric body composition analysis with dual-energy X-ray absorptiometry. Pediatr Radiol 2009;39:647-56. https://doi.org/10.1007/s00247-009-1247-0
  21. Perlemuter G, Naveau S, Belle-Croix F, Buffet C, Agostini H, Laromiguiere M, et al. Independent and opposite associations of trunk fat and leg fat with liver enzyme levels. Liver Int 2008;28:1381-8. https://doi.org/10.1111/j.1478-3231.2008.01764.x
  22. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97. https://doi.org/10.1001/jama.285.19.2486
  23. Lin YC, Chang PF, Yeh SJ, Liu K, Chen HC. Risk factors for liver steatosis in obese children and adolescents. Pediatr Neonatol 2010;51:149-54. https://doi.org/10.1016/S1875-9572(10)60028-9
  24. Monteiro PA, Antunes Bde M, Silveira LS, Christofaro DG, Fernandes RA, Freitas Junior IF. Body composition variables as predictors of NAFLD by ultrasound in obese children and adolescents. BMC Pediatr 2014;14:25. https://doi.org/10.1186/1471-2431-14-25
  25. Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 2010;95:1777-85. https://doi.org/10.1210/jc.2009-1584
  26. Hsieh SD, Yoshinaga H, Muto T. Waist-to-height ratio, a simple and practical index for assessing central fat distribution and metabolic risk in Japanese men and women. Int J Obes Relat Metab Disord 2003;27:610-6. https://doi.org/10.1038/sj.ijo.0802259
  27. Savva SC, Tornaritis M, Savva ME, Kourides Y, Panagi A, Silikiotou N, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord 2000;24:1453-8. https://doi.org/10.1038/sj.ijo.0801401
  28. Weili Y, He B, Yao H, Dai J, Cui J, Ge D, et al. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity (Silver Spring) 2007;15:748-52. https://doi.org/10.1038/oby.2007.601
  29. Lee KK, Park HS, Yum KS. Cut-off values of visceral fat area and waist-to-height ratio: diagnostic criteria for obesity-related disorders in Korean children and adolescents. Yonsei Med J 2012;53:99-105. https://doi.org/10.3349/ymj.2012.53.1.99
  30. Olynyk JK, Knuiman MW, Divitini ML, Davis TM, Beilby J, Hung J. Serum alanine aminotransferase, metabolic syndrome, and cardiovascular disease in an Australian population. Am J Gastroenterol 2009;104:1715-22. https://doi.org/10.1038/ajg.2009.229
  31. Aigner E, Hinz C, Steiner K, Rossmann B, Pfleger J, Hohla F, et al. Iron stores, liver transaminase levels and metabolic risk in healthy teenagers. Eur J Clin Invest 2010;40:155-63. https://doi.org/10.1111/j.1365-2362.2009.02238.x
  32. Grotti Clemente AP, Molin Netto BD, Ganen Ad, Tock L, Arisa Caranti D, de Mello MT, et al. Cut-off values of visceral adiposity to predict NAFLD in Brazilian obese adolescents. J Nutr Metab 2013;2013:724781.
  33. Clark JM, Brancati FL, Diehl AM. Nonalcoholic fatty liver disease. Gastroenterology 2002;122:1649-57. https://doi.org/10.1053/gast.2002.33573
  34. Deutsch M, Mueller WH, Malina RM. Androgyny in fat patterning is associated with obesity in adolescents and young adults. Ann Hum Biol 1985;12:275-86. https://doi.org/10.1080/03014468500007781

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