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Association of cardiometabolic risk factors and hepatic enzymes in a national sample of Iranian children and adolescents: the CASPIAN-III study.
J Pediatr Gastroenterol Nutr. 2014 Apr; 58(4):463-8.JP

Abstract

OBJECTIVES

Elevated liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may be associated with metabolic syndrome (MetS) and cardiovascular disease. We investigated the association of cardiometabolic risk factors and liver enzymes in a nationally representative sample of Iranian children and adolescents.

METHODS

The national study was conducted in the framework of the third survey of Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable Disease study. Subjects were 3948 students (1942 girls, 67.55% urban, mean age 14.7 ± 2.4 years) who were recruited by multistage random cluster sampling from 27 provincial counties in Iran. Physical examination and laboratory tests were conducted under standard protocols.

RESULTS

Participants with elevated serum ALT had higher levels of almost all cardiometabolic risk factors than other participants; this difference was not significant for fasting blood glucose, total cholesterol, and diastolic blood pressure in both sexes, as well as low-density lipoprotein cholesterol in girls. Participants with generalized and abdominal obesity, MetS, elevated blood pressure, triglycerides, and total cholesterol had increased risk for elevated ALT; this risk remained significant after adjusting for sex and age. Low high-density lipoprotein cholesterol was found as a predictor for both elevated ALT (odds ratio 2.182, 95% confidence interval 1.533-3.105) and AST (odds ratio 2.022, 95% confidence interval 1.438-2.844) even after adjusting for all potential confounders. General (B 0.158, SE 0.030) and abdominal obesity (B 0.058, SE 0.029), MetS (B 0.231, SE 0.048), and triglycerides (B 0.094, SE 0.030) were associated with ALT:AST ratio after adjusting for all potential confounders (P < 0.001).

CONCLUSIONS

We documented strong relations of elevated ALT, AST levels, and ALT:AST ratio with most cardiometabolic risk factors. This relation was independent of anthropometric indexes. Liver enzymes can be considered as a cardiometabolic risk factor from childhood, and as an additional component of the MetS.

Authors+Show Affiliations

*Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran †Department of Public Health, Alborz University of Medical Sciences, Karaj ‡Pediatrics Department, Child Growth and Development Research Center, and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan §Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran ¶Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz #Department of Medical Emergencies, Qom University of Medical Sciences, Qom **Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24253369

Citation

Mohammadi, Fatemeh, et al. "Association of Cardiometabolic Risk Factors and Hepatic Enzymes in a National Sample of Iranian Children and Adolescents: the CASPIAN-III Study." Journal of Pediatric Gastroenterology and Nutrition, vol. 58, no. 4, 2014, pp. 463-8.
Mohammadi F, Qorbani M, Kelishadi R, et al. Association of cardiometabolic risk factors and hepatic enzymes in a national sample of Iranian children and adolescents: the CASPIAN-III study. J Pediatr Gastroenterol Nutr. 2014;58(4):463-8.
Mohammadi, F., Qorbani, M., Kelishadi, R., Baygi, F., Ardalan, G., Taslimi, M., Mahmoudarabi, M., Motlagh, M. E., Asayesh, H., Larijani, B., & Heshmat, R. (2014). Association of cardiometabolic risk factors and hepatic enzymes in a national sample of Iranian children and adolescents: the CASPIAN-III study. Journal of Pediatric Gastroenterology and Nutrition, 58(4), 463-8. https://doi.org/10.1097/MPG.0000000000000246
Mohammadi F, et al. Association of Cardiometabolic Risk Factors and Hepatic Enzymes in a National Sample of Iranian Children and Adolescents: the CASPIAN-III Study. J Pediatr Gastroenterol Nutr. 2014;58(4):463-8. PubMed PMID: 24253369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of cardiometabolic risk factors and hepatic enzymes in a national sample of Iranian children and adolescents: the CASPIAN-III study. AU - Mohammadi,Fatemeh, AU - Qorbani,Mostafa, AU - Kelishadi,Roya, AU - Baygi,Fereshteh, AU - Ardalan,Gelayol, AU - Taslimi,Mahnaz, AU - Mahmoudarabi,Minoosadat, AU - Motlagh,Mohammad-Esmaeil, AU - Asayesh,Hamid, AU - Larijani,Bagher, AU - Heshmat,Ramin, PY - 2013/11/21/entrez PY - 2013/11/21/pubmed PY - 2015/1/16/medline SP - 463 EP - 8 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 58 IS - 4 N2 - OBJECTIVES: Elevated liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may be associated with metabolic syndrome (MetS) and cardiovascular disease. We investigated the association of cardiometabolic risk factors and liver enzymes in a nationally representative sample of Iranian children and adolescents. METHODS: The national study was conducted in the framework of the third survey of Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable Disease study. Subjects were 3948 students (1942 girls, 67.55% urban, mean age 14.7 ± 2.4 years) who were recruited by multistage random cluster sampling from 27 provincial counties in Iran. Physical examination and laboratory tests were conducted under standard protocols. RESULTS: Participants with elevated serum ALT had higher levels of almost all cardiometabolic risk factors than other participants; this difference was not significant for fasting blood glucose, total cholesterol, and diastolic blood pressure in both sexes, as well as low-density lipoprotein cholesterol in girls. Participants with generalized and abdominal obesity, MetS, elevated blood pressure, triglycerides, and total cholesterol had increased risk for elevated ALT; this risk remained significant after adjusting for sex and age. Low high-density lipoprotein cholesterol was found as a predictor for both elevated ALT (odds ratio 2.182, 95% confidence interval 1.533-3.105) and AST (odds ratio 2.022, 95% confidence interval 1.438-2.844) even after adjusting for all potential confounders. General (B 0.158, SE 0.030) and abdominal obesity (B 0.058, SE 0.029), MetS (B 0.231, SE 0.048), and triglycerides (B 0.094, SE 0.030) were associated with ALT:AST ratio after adjusting for all potential confounders (P < 0.001). CONCLUSIONS: We documented strong relations of elevated ALT, AST levels, and ALT:AST ratio with most cardiometabolic risk factors. This relation was independent of anthropometric indexes. Liver enzymes can be considered as a cardiometabolic risk factor from childhood, and as an additional component of the MetS. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/24253369/Association_of_cardiometabolic_risk_factors_and_hepatic_enzymes_in_a_national_sample_of_Iranian_children_and_adolescents:_the_CASPIAN_III_study_ L2 - https://doi.org/10.1097/MPG.0000000000000246 DB - PRIME DP - Unbound Medicine ER -