Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease.
Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease.
复制标题
DOI：
10.3390/children9030374
复制
发表时间：
2022-03-08
期刊：
影响因子：
--
通讯作者：
Target-Nash Investigators
中科院分区：
文献类型：
--
作者：
Castillo-Leon E;Morris HL;Schoen C;Bilhartz J;McKiernan P;Miloh T;Palle S;Kabbany MN;Munoz B;Mospan AR;Rudolph B;Xanthakos SA;Vos MB;Target-Nash Investigators
背景：儿童非酒精性脂肪性肝病（NAFLD）是一个主要的公共卫生问题。转氨酶（ALT）常用于筛查和监测，但很少有研究报道儿童ALT升高的典型模式。方法：TARGET-NASH是一个在美国接受治疗的NAFLD患者的真实世界纵向观察队列。分析包括2016年8月1日至2020年10月12日期间入组的儿童，入组后至少进行了一次ALT测量。峰值ALT基于第一个和最后一个可用记录，并分为临床临界点：<70 IU/L，>70-<250 IU/L和>250 IU/L。使用卡方检验比较比例差异，使用Kruskal-Wallis检验比较连续应答的中位数和分布。结果：分析包括660名儿童，中位年龄为13岁。在这660例患者中，共有187例接受了活检，更有可能是西班牙裔或拉丁裔（67%对57%，p = 0.02）和肝硬化（10%对1%，p < 0.001）。最高ALT评分范围为28 U/L至929 U/L;然而，这些评分随时间变化。肝硬化或任何肝纤维化阶段的患病率在ALT峰值> 70 U/L的儿童中最常见。结论：儿童ALT变异性较大，包括许多> 250 U/L的值。ALT水平升高与合并症患病率增加和NAFLD分期更晚期相关。这些发现支持对ALT峰值> 70 U/L的儿童进行治疗和疾病严重程度评估的需求增加。
Background: Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health concern. Aminotransferase (ALT) is frequently used for screening and monitoring, but few studies have reported typical patterns of ALT elevation in children. Methods: TARGET-NASH is a real-world longitudinal observational cohort of patients with NAFLD receiving care across the United States. Analyses included children enrolled between 1 August 2016, and 12 October 2020, with at least one ALT measurement after enrollment. Peak ALT was based on the first and last available record and categorized into clinical cut points: <70 IU/L, >70–<250 IU/L, and >250 IU/L. A chi-squared test was used to compare differences in proportions, and a Kruskal–Wallis test was used to compare the medians and distributions of continuous responses. Results: Analyses included 660 children with a median age of 13 years. Of the 660, a total of 187 had undergone a biopsy and were more likely to be Hispanic or Latino (67% vs. 57%, p = 0.02) and to have cirrhosis (10% vs. 1%, p < 0.001). The highest ALT scores ranged from 28 U/L to 929 U/L; however, these scores varied across time. The prevalence of cirrhosis or any liver fibrosis stage was most common among children with a peak ALT > 70 U/L. Conclusions: Large variability was seen in ALT among children, including many values > 250 U/L. Higher levels of ALT were associated with increased prevalence of comorbidities and more advanced stages of NAFLD. These findings support an increased need for therapeutics and disease severity assessment in children with peak ALT > 70 U/L.
登录
查看更多内容
影响因子：
9.8
作者：
Patton, Heather M.;Yates, Katherine;Unalp-Arida, Aynur;Behling, Cynthia A.;Huang, Terry T. -K.;Rosenthal, Philip;Sanyal, Arun J.;Schwimmer, Jeffrey B.;Lavine, Joel E.
通讯作者：
Lavine, Joel E.
影响因子：
24.5
作者：
Feldstein AE;Charatcharoenwitthaya P;Treeprasertsuk S;Benson JT;Enders FB;Angulo P
通讯作者：
Angulo P
DOI：
10.1097/mpg.0000000000001482
发表时间：
2017-02
影响因子：
2.9
作者：
Vos MB;Abrams SH;Barlow SE;Caprio S;Daniels SR;Kohli R;Mouzaki M;Sathya P;Schwimmer JB;Sundaram SS;Xanthakos SA
通讯作者：
Xanthakos SA
影响因子：
6.9
作者：
Holterman, Ai-Xuan L.;Guzman, Grace;Holterman, Mark
通讯作者：
Holterman, Mark
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F