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Acta Médica Peruana
versão On-line ISSN 1728-5917
Resumo
CABRERA, Ysel et al. Alanine aminotransferase as a marker for diagnosing metabolic syndrome and cardiovascular risk in obese children. Acta méd. Peru [online]. 2019, vol.36, n.4, pp.253-258. ISSN 1728-5917.
Objective: To assess alanine aminotransferase (ALT) as a marker for diagnosing metabolic syndrome (MS) and cardiovascular risk in children with exogenous obesity. Materials and Methods: This is a cross-sectional study. Children with exogenous obesity between 2 and 14 years of age seen in the Pediatric Endocrinology Unit at Cayetano Heredia Hospital between 2014 and 2018 were included. Non alcoholic liver disease was defined considering two ALT cutoff points: >22.1 U/L and >44 U/L in females and >25.8 U/L and >50 U/L in males. MS was defined according to the American Academy of Pediatrics criteria, and cardiovascular risk was defined with TG/HDL-C ratio ³3.5. We used chi-square test, and p<0.05 was deemed as significant. We estimated sensitivity (S), specificity (E) and likelihood ratios (LR). Results: Three-hundred and forty-seven obese children were included (54.7% were male). Non-alcoholic liver disease frequency was 23.1%. Sensitivity and specificity values for diagnosing MS with ALT >22.1 U/L and >25.8 U/L were 79.4% and 37.6%, respectively; and with ALT >44 U/L and 50 U/L these values were 28.6% and 83.3%. ALT levels with higher cutoff values, together with a ³3.5 TG/HDL-C ratio showed 96.9% specificity and 6.7 likelihood ratio (LR+). Conclusion: ALT levels with a >44 U/L cutoff value in females and >50 U/L in males is a useful biochemical marker for identifying MS and determining cardiovascular risk in children with exogen obesity during their early years of life.
Palavras-chave : Alanine transaminase; Metabolic syndrome; Cardiovascular diseases; Non-alcoholic fatty liver disease.