Abstract
BackgroundTo examine the influence of ethnicity on liver transaminases among adolescents with type 2 diabetes mellitus (T2DM).MethodsA retrospective medical chart review of 57 (30 males and 27 females) newly diagnosed patients with T2DM. Ethnicity was determined by self-report and height, weight, body mass index (BMI) and glycosylated hemoglobin (HbA1c) were obtained using standard clinical procedures. Fasting levels of alanine aminotransaminase (ALT) and aspartate aminotransferase (AST) were collected prior to the initiation of any therapy.ResultsAge, gender, height, weight, BMI, and HbA1c did not differ between ethnic groups. Compared to African-Americans, Hispanics had significantly higher ALT (23.9 ± 3.4 vs. 107.8 ± 20.3, p=0.002) and AST (17.7 ± 2.5 vs. 71.1 ± 15.7, p<0.001) and were significantly more likely to have ALT values above the upper limit of normal (20% vs. 71%, p=0.005) and twice the upper limit of normal (0% vs. 39%, p=0.05) as well as AST values above the upper limit of normal (0% vs. 53%, p=0.002). No differences in ALT or AST were found between Hispanics and non-Hispanic whites or between African-Americans and non-Hispanic whites.ConclusionsThese preliminary findings suggest that Hispanic children with T2DM may be at higher risk for developing non-alcoholic fatty liver disease and indicate that a comprehensive hepatic evaluation is warranted in this population. Future studies that incorporate more precise and proximal measures of liver health are warranted in this population.
Highlights
To examine the influence of ethnicity on liver transaminases among adolescents with type 2 diabetes mellitus (T2DM)
Hispanic and African-American adolescents are more likely to present with T2DM compared to non-Hispanic whites but Hispanic adolescents are thought to be at highest risk for nonalcoholic fatty liver disease (NAFLD) while African-Americans are at lowest risk [7]
Both Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) differed by ethnicity (R2 = 0.20, F = 6.768, p = 0.002 for ALT and R2 = 0.24, F = 8.804, p < 0.001 for AST) with pair-wise comparisons showing Hispanic youth with significantly higher ALT (p = 0.002) and AST (P < 0.001) levels compared to African-Americans
Summary
To examine the influence of ethnicity on liver transaminases among adolescents with type 2 diabetes mellitus (T2DM). Childhood obesity is increasing worldwide and nearly 35% of children and adolescents in the United States are overweight or obese [1] Coinciding with this epidemic is an increase in obesity-related metabolic comorbidities such as type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) [2,3]. These chronic conditions present challenges to pediatric practitioners as no consensus on their management exists and there is limited evidence regarding long-term prognosis. No studies have examined the degree to which liver transaminases are differentially elevated across ethnic groups among youth diagnosed with
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