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Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study

(2015) PEDIATRIC OBESITY. 10(5). p.361-370
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Abstract
Objectives: This study aimed to explore the associations of liver biomarkers with cardiometabolic risk factors and their clustering, and to provide reference values (percentiles) and cut-off points for liver biomarkers associated with high cardiometabolic risk in European adolescents. Methods: Alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase to ALT ratio (AST/ALT), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin were measured in 1084 adolescents. We computed a continuous cardiometabolic risk score and defined the high cardiometabolic risk. Results: Higher ALT and GGT and lower AST/ALT were associated with adiposity and with the number of adverse cardiometabolic risk factors (Ps < 0.05). Higher GGT and lower AST/ALT were associated with higher cardiometabolic risk score (Ps < 0.001) in males and females, and ALT only in males (Ps < 0.001). Gender-and age-specific percentiles for liver biomarkers were provided. Receiver operating characteristic analyses showed a significant discriminatory accuracy of AST/ALT in identifying the low/high cardiometabolic risk (Ps < 0.01) and thresholds were provided. Conclusions: Higher GGT and lower AST/ALT are associated with higher cardiometabolic risk factors and their clustering in male and female European adolescents, whereas the associations of ALT were gender dependent. Our results suggest the usefulness of AST/ALT as a screening test in the assessment of adolescents with high cardiometabolic risk and provide gender-and age-specific thresholds that might be of clinical interest.
Keywords
obesity, Liver, cardiometabolic risk factors, adolescents, INSULIN-RESISTANCE, FATTY LIVER, ALANINE AMINOTRANSFERASE, CARDIOVASCULAR RISK, METABOLIC SYNDROME, OBESE CHILDREN, VISCERAL FAT, CASPIAN-III, DISEASE, CHILDHOOD

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Citation

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Chicago
Labayen, I, JR Ruiz, FB Ortega, CL Davis, G Rodríguez, M González-Gross, C Breidenassel, et al. 2015. “Liver Enzymes and Clustering Cardiometabolic Risk Factors in European Adolescents: The HELENA Study.” Pediatric Obesity 10 (5): 361–370.
APA
Labayen, I, Ruiz, J., Ortega, F., Davis, C., Rodríguez, G., González-Gross, M., Breidenassel, C., et al. (2015). Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study. PEDIATRIC OBESITY, 10(5), 361–370.
Vancouver
1.
Labayen I, Ruiz J, Ortega F, Davis C, Rodríguez G, González-Gross M, et al. Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study. PEDIATRIC OBESITY. 2015;10(5):361–70.
MLA
Labayen, I, JR Ruiz, FB Ortega, et al. “Liver Enzymes and Clustering Cardiometabolic Risk Factors in European Adolescents: The HELENA Study.” PEDIATRIC OBESITY 10.5 (2015): 361–370. Print.
@article{7066099,
  abstract     = {Objectives: This study aimed to explore the associations of liver biomarkers with cardiometabolic risk factors and their clustering, and to provide reference values (percentiles) and cut-off points for liver biomarkers associated with high cardiometabolic risk in European adolescents. 
Methods: Alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase to ALT ratio (AST/ALT), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin were measured in 1084 adolescents. We computed a continuous cardiometabolic risk score and defined the high cardiometabolic risk. 
Results: Higher ALT and GGT and lower AST/ALT were associated with adiposity and with the number of adverse cardiometabolic risk factors (Ps {\textlangle} 0.05). Higher GGT and lower AST/ALT were associated with higher cardiometabolic risk score (Ps {\textlangle} 0.001) in males and females, and ALT only in males (Ps {\textlangle} 0.001). Gender-and age-specific percentiles for liver biomarkers were provided. Receiver operating characteristic analyses showed a significant discriminatory accuracy of AST/ALT in identifying the low/high cardiometabolic risk (Ps {\textlangle} 0.01) and thresholds were provided. 
Conclusions: Higher GGT and lower AST/ALT are associated with higher cardiometabolic risk factors and their clustering in male and female European adolescents, whereas the associations of ALT were gender dependent. Our results suggest the usefulness of AST/ALT as a screening test in the assessment of adolescents with high cardiometabolic risk and provide gender-and age-specific thresholds that might be of clinical interest.},
  author       = {Labayen, I and Ruiz, JR and Ortega, FB and Davis, CL and Rodr{\'i}guez, G and Gonz{\'a}lez-Gross, M and Breidenassel, C and Dallongeville, J and Marcos, A and Widhalm, K and Kafatos, A and Molnar, D and De Henauw, Stefaan and Gottrand, F and Moreno, LA},
  issn         = {2047-6310},
  journal      = {PEDIATRIC OBESITY},
  language     = {eng},
  number       = {5},
  pages        = {361--370},
  title        = {Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study},
  url          = {http://dx.doi.org/10.1111/ijpo.273},
  volume       = {10},
  year         = {2015},
}

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