Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004
Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004
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DOI：
10.1053/j.gastro.2007.08.077
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发表时间：
2007-12-01
期刊：
影响因子：
29.4
通讯作者：
Lawlor, Debbie A.
中科院分区：
文献类型：
--
作者：
Fraser, Abigail;Longnecker, Matthew P.;Lawlor, Debbie A.
背景与目标：非酒精性脂肪肝病（NAFLD）是儿童和青少年肝病的常见原因。大多数关于儿童 NAFLD 的研究都是在特定的临床肥胖人群中进行的。研究目的是估计当代青少年人群中丙氨酸氨基转移酶（ALT，作为 NAFLD 的标志）升高的患病率，并确定 ALT 升高（> 30 U/L）的主要危险因素。方法：我们分析了 1999-2004 年国家健康和营养检查调查中青少年参与者（12-19 岁；N = 5586）的数据，这是美国非机构化平民人口的代表性样本。结果： ALT 水平升高（> 30 U/L）的患病率在白人青少年中为 7.4%，在墨西哥裔美国青少年中为 11.5%，在黑人青少年中为 6.0%。 12.4% 的男性受试者普遍存在 ALT 水平升高，而女性受试者中这一比例为 3.5%。性别（比值比 [OR] 男性与女性，7.7；95% 置信区间 [CI]，3.9-15.1）、种族（OR 黑人与白人，0.6；95% CI，0.3-1.3；OR 墨西哥裔美国人与白人，1.6；95% CI，1.0-2.6）、腰围（OR 每 1 SD， 1.4；95% CI，1.0-2.0）和空腹胰岛素水平（OR 每 I SD，1.6；95% CI，1.2-2.1）。年龄、C 反应蛋白水平和甘油三酯水平也与 ALT 水平升高呈正相关，社会经济地位与 ALT 水平呈负相关。不同种族之间的关联程度相似。结论：即使在年轻人中，ALT 水平也与腰围和胰岛素抵抗相关。这些特征可用于识别可能受益于 NAFLD 筛查的青少年，从而提供在早期预防疾病进展的机会。
Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is a common cause of liver disease in children and adolescents. The majority of studies of NAFLD in children have been in select populations of the clinically obese. Study aims were to estimate the prevalence of elevated alanine aminotransferase (ALT, as a marker of NAFLD) in a general contemporary adolescent population and to identify leading risk factors for ALT elevation (>30 U/L). Metho : We analyzed data of adolescent participants (aged 12-19 years; N = 5586) in the National Health and Nutrition Examination Survey 1999-2004, a representative sample of the civilian noninstitutionalized US population. Results: The prevalence of elevated ALT levels (>30 U/L) was 7.4% among white adolescents, 11.5% among Mexican American adolescents, and 6.0% among black adolescents. Elevated ALT levels were prevalent in 12.4% of male subjects compared with 3.5% of female subjects. Multivariable associations with elevated ALT levels were found for sex (odds ratio [OR] male vs female, 7.7; 95% confidence interval [CI], 3.9-15.1), ethnicity (OR black vs white, 0.6; 95% CI, 0.3-1.3; OR Mexican American vs white, 1.6; 95% CI, 1.0-2.6), waist circumference (OR per 1 SD, 1.4; 95% CI, 1.0-2.0), and fasting insulin level (OR per I SD, 1.6; 95% CI, 1.2-2.1). Age, C-reactive protein levels, and triglyceride levels were also positively and socioeconomic position inversely associated with elevated ALT levels. The magnitude of associations were similar across ethnic groups. Conclusions: ALT level is associated with waist circumference and insulin resistance even in a young population. These characteristics could be utilized to identify adolescents who may benefit from screening for NAFLD, offering an opportunity to prevent disease progression at an early age.