Type 2 diabetes in children is frequently associated with elevated alanine aminotransferase
Type 2 diabetes in children is frequently associated with elevated alanine aminotransferase
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DOI：
10.1097/01.mpg.0000164698.03164.e5
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发表时间：
2005-07-01
影响因子：
2.9
通讯作者：
Zeitler, T
中科院分区：
文献类型：
--
作者：
Nadeau, KJ;Klingensmith, T;Zeitler, T
背景：非酒精性脂肪性肝病是肥胖成人慢性肝病的一个原因，也发生在肥胖儿童中。在易感人群中，脂肪肝进展为非酒精性脂肪性肝炎，最终发展为纤维化和肝硬化。非酒精性脂肪性肝炎与丙氨酸氨基转移酶升高有关，尽管转氨酶也可能正常。2型糖尿病患者非酒精性脂肪肝的患病率在成人和儿童中尚不清楚。目的：本研究的目的是评估血清转氨酶升高作为儿童2型糖尿病患者非酒精性脂肪肝的标志物的患病率，并确定转氨酶升高的相关性。方法：在儿科糖尿病诊所完成了对115名2型糖尿病儿童的图表审查。丙氨酸氨基转移酶升高的患病率从42%的患者可用的转氨酶测量值和相关性与空腹血脂，血红蛋白A-1C，体重指数，年龄和糖尿病therapeutic were searched.Results：丙氨酸氨基转移酶升高的患病率为48%。海拔与其他变量之间没有关联。在丙氨酸氨基转移酶升高的受试者中，39%高于正常值1至2倍，26%高于正常值2至3倍，35%高于正常值3倍以上。几个病人经历了使用insulin-sensitizing medicines.Conclusions后，转氨酶升高的改善：有一个高患病率血清转氨酶升高的2型糖尿病儿童无关的年龄，体重指数，血糖控制，血脂或糖尿病治疗。这种异常的意义及其与非酒精性脂肪肝的关系需要进一步评估。
Background: Nonalcoholic fatty liver disease, a cause of chronic liver disease in obese adults also occurs in obese children. In susceptible populations, fatty liver progresses to nonalcoholic steatohepatitis and eventually to fibrosis and cirrhosis. Nonalcoholic steatohepatitis is associated with elevation of alanine aminotransferase, although the aminotransferases can also be normal. The prevalence of nonalcoholic fatty liver disease in type 2 diabetes is unclear in adults and unknown in children.Objectives: The aim of this study was to estimate the prevalence of elevated serum aminotransferases as a marker of nonalcoholic fatty liver disease in pediatric type 2 diabetes and to identify correlates of aminotransferase elevation.Methods: A chart review was completed on 115 children with type 2 diabetes at a pediatric diabetes clinic. The prevalence of elevated alanine aminotransferase was calculated from the 42% of patients with available aminotransferase measurements and correlations with fasting lipids, hemoglobin A-1c, body mass index, age and diabetes therapy were sought.Results: The prevalence of elevated alanine aminotransferase was 48%. There was no association between elevations and other variables. Among subjects with elevated alanine aminotransferase, 39% were one to two times above normal, 26% were two to three times normal and 35% were greater than three times above normal. Several patients experienced improvement in aminotransferase elevations after using insulin-sensitizing medications.Conclusions: There is a high prevalence of elevated serum aminotransferases among children with type 2 diabetes unrelated to age, body mass index, glycemic control, blood lipids or diabetic therapy. The significance of this abnormality and its relationship to nonalcoholic fatty liver disease requires further evaluation.