P0039 PP INCIDENCE OF ABNORMAL LIVER ENZYMES IN OBESE CHILDREN REFERRED FOR WEIGHT REDUCTION PROGRAM

Abstract

Introduction: Nonalcoholic fatty infiltration of the liver is a known sequel of obesity in adults. It has previously been reported that fatty infiltration of the liver affects 2.6% of children and 10–25% adolescents with obesity. Serum levels of alanine (ALT) and aspartate aminotransferase (AST) have been proposed as surrogate markers of hepatic fat accumulation. We describe the incidence of abnormal liver enzymes in obese children involved in Kids–Weight Down Program and attempt to seek correlations between other variables associated with insulin resistance. Methods: One hundred fifty six (ages 5 to 20 years) obese children were enrolled. Liver enzymes, fasting lipid profile, thyroid function tests, glucose and insulin levels were obtained and screened. Results: ALT and AST were elevated in 30/156 (19.2 %) children with obesity and normal glucose tolerance. In the group with elevated liver enzymes, HDL was significantly lower and triglycerides (TG) were significantly higher (P <0.001). TG level correlated positively with ALT level (r=0.39, P< 0.001). While HDL negatively correlated with ALT level (r= − 0.29, p <0.001). Ratio TG/HDL correlated with ALT (r= 0.37, p <0.001) and AST (r=0.27, p< 0.001). Frequency of elevated liver transaminases increases with age: from 15% at 5–10 years of age, to 18 % at 11 to 15 years and 31 % at 16-to 20 years of age. There were no differences in insulin resistance index (QUICKI), BMI or age between groups. Conclusion: Elevated liver transaminases are a frequent complication of obesity in up to 19 % of our patients. Frequency of such complications increases with age. Elevated TG/HDL index can be a marker of abnormal liver enzymes, an important surrogate marker of fatty infiltration of the liver.