Prevalence of elevated liver enzymes and comorbidities in children and adolescents with overweight and obesity

AIM We investigated the prevalence of elevated liver aminotrasferases (ALT) and additional comorbidities in a large cohort of Israeli children and adolescents with overweight and obesity. METHODS This study included data from medical records of 2 to 18 year old children and adolescents, with body mass index (BMI) in the overweight or obesity range (WHO definitions), for whom ALT testing was performed. RESULTS Overweight was present in 50418 (10.7%) and obesity in 70515 (15.0%). Elevated ALT, above 30 IU/L (0.51 μkat/L), was reported in 2245 (7.2%) of children with overweight and 5475 (16.8%) of children with obesity (p<0.0001). Compared to children with overweight and obesity and ALT within normal range, children with elevated ALT were older (11.9±4.2 vs 10.9±4.2, p<0.001), mostly male (68.0% vs 49.4%, p<0.001) and had higher BMI (27.3±6.1vs 24.0±4.8, p<0.001). They also had a more unfavorable cardio-metabolic profile with significantly higher either systolic or diastolic blood pressure, total cholesterol and triglycerides, and had more than three criteria defining metabolic syndrome. CONCLUSION In this large cohort, abnormally elevated ALT was present in a high number of individuals with overweight or obesity. The children and adolescents with abnormal ALT had higher BMI, were older, male and had more cardio-metabolic risk factors.