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Elevated transaminases potentiate the risk for emerging dysglycemia in children with overweight and obesity

Florian Koutny1,2, Robert Stein3,4, Wieland Kiess3,5

  • 1Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria.

Pediatric Obesity
|June 22, 2021
PubMed

Insights

Elevated liver enzymes, indicating nonalcoholic fatty liver disease (NAFLD), predict future dysglycemia in children with obesity. Early NAFLD detection is crucial for preventing type 2 diabetes.

Area of Science:

  • Pediatrics
  • Hepatology
  • Endocrinology

Background:

  • Nonalcoholic fatty liver disease (NAFLD) is linked to dysglycemia in children, but longitudinal data are limited.
  • Cross-sectional studies suggest a connection, yet the predictive value of NAFLD for future dysglycemia in children requires further investigation.

Purpose of the Study:

  • To determine if elevated alanine aminotransferase (ALT) levels, a marker for NAFLD, predict future dysglycemia in children.
  • To assess the longitudinal association between NAFLD indicators and dysglycemia development in pediatric populations.

Main Methods:

  • Survival analysis was conducted on longitudinal data from 510 children with overweight and obesity.
  • Follow-up extended up to 11 years, utilizing data from the Leipzig Childhood Cohort.
  • Elevated ALT levels served as a proxy for NAFLD in the analysis.

Main Results:

  • Children with overweight/obesity and elevated ALT showed a >2-fold increased risk for future dysglycemia (HR 2.59, P < 0.01).
  • This increased risk was independent of age, sex, and BMI-SDS.
  • Elevated transaminases emerged as a significant early predictor of glycemic deterioration.

Conclusions:

  • Elevated transaminases are an early predictor of glycemic deterioration in children.
  • NAFLD should be recognized as a significant risk factor for type 2 diabetes.
  • Targeting NAFLD is essential for the early prevention of type 2 diabetes in pediatric populations.
Abstract

Keywords:
childhood obesitydysglycemiaearly-onset diabetesnonalcoholic fatty liver diseaseprediabetestype 2 diabetes

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