Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Obesity Pub Date : 2024-03-05 DOI:10.1111/ijpo.13110

Catherine Lee, Jeffrey B. Schwimmer, Erica P. Gunderson, Nidhi P. Goyal, Jeanne A. Darbinian, Louise C. Greenspan, Joan C. Lo

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Abstract

Background

Limited research on alanine aminotransferase (ALT) screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among US Asian/Pacific Islander (PI) children necessitates investigation in this heterogeneous population.

Objective

Examine ALT elevation among Asian/PI children with overweight or obesity.

Methods

Elevated ALT prevalence (clinical threshold) and association with body mass index ≥85th percentile were compared among 18 402 Asian/PI and 25 376 non-Hispanic White (NHW) children aged 9–17 years using logistic regression.

Results

ALT elevation was more prevalent among Asian/PI (vs. NHW) males with overweight (4.0% vs. 2.7%), moderate (7.8% vs. 5.3%) and severe obesity (16.6% vs. 11.5%), and females with moderate (5.1% vs. 3.0%) and severe obesity (10.2% vs. 5.2%). Adjusted odds of elevated ALT were 1.6-fold and ~2-fold higher for Asian/PI (vs. NHW) males and females (with obesity), respectively. Filipino, Chinese and Southeast Asian males had 1.7–2.1-fold higher odds, but Native Hawaiian/PI (NHPI) and South Asian males did not significantly differ (vs. NHW). Filipina and Chinese females with obesity had >2-fold higher odds, Southeast and South Asian females did not differ and NHPI findings were mixed (vs. NHW).

Conclusion

High elevated ALT prevalence among Asian/PI children with overweight and obesity emphasizes the need for MASLD risk assessment and examination of ethnic subgroups.

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在超重或肥胖的亚太裔儿童中，丙氨酸氨基转移酶的升高因种族而异。

背景：美国亚太裔（PI）儿童丙氨酸氨基转移酶（ALT）筛查代谢功能障碍相关性脂肪性肝病（MASLD）的研究有限，因此有必要对这一异质性人群进行调查：研究超重或肥胖的亚裔/太平洋岛民儿童的 ALT 升高情况：采用逻辑回归法比较了 18 402 名 9-17 岁亚裔/PI 儿童和 25 376 名非西班牙裔白人（NHW）儿童的 ALT 升高率（临床阈值）以及与体重指数≥85 百分位数的关系：ALT升高在超重（4.0% vs. 2.7%）、中度肥胖（7.8% vs. 5.3%）和重度肥胖（16.6% vs. 11.5%）的亚裔/PI（vs. NHW）男性以及中度肥胖（5.1% vs. 3.0%）和重度肥胖（10.2% vs. 5.2%）的女性中更为普遍。亚裔/菲律宾裔（与非正常体重者相比）男性和女性（肥胖）ALT 升高的调整几率分别高出 1.6 倍和 2 倍。菲律宾裔、华裔和东南亚裔男性的几率高出 1.7-2.1 倍，但夏威夷原住民/菲律宾裔（NHPI）和南亚裔男性（与 NHW 相比）并无显著差异。菲律宾裔和华裔女性肥胖者的几率高出 2 倍以上，东南亚和南亚女性没有差异，而夏威夷原住民/菲律宾裔（NHPI）和南亚男性的结果不一（与 NHW 相比）：结论：在超重和肥胖的亚裔/菲律宾裔儿童中，谷丙转氨酶升高的发生率很高，这强调了对种族亚群进行 MASLD 风险评估和检查的必要性。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.