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Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease

Background: Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health concern. Aminotransferase (ALT) is frequently used for screening and monitoring, but few studies have reported typical patterns of ALT elevation in children. Methods: TARGET-NASH is a real-world longitudinal obs...

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Autores principales: Castillo-Leon, Eduardo, Morris, Heather L., Schoen, Cheryl, Bilhartz, Jacob, McKiernan, Patrick, Miloh, Tamir, Palle, Sirish, Kabbany, Mohammad Nasser, Munoz, Breda, Mospan, Andrea R., Rudolph, Bryan, Xanthakos, Stavra A., Vos, Miriam B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946883/
https://www.ncbi.nlm.nih.gov/pubmed/35327746
http://dx.doi.org/10.3390/children9030374
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author Castillo-Leon, Eduardo
Morris, Heather L.
Schoen, Cheryl
Bilhartz, Jacob
McKiernan, Patrick
Miloh, Tamir
Palle, Sirish
Kabbany, Mohammad Nasser
Munoz, Breda
Mospan, Andrea R.
Rudolph, Bryan
Xanthakos, Stavra A.
Vos, Miriam B.
author_facet Castillo-Leon, Eduardo
Morris, Heather L.
Schoen, Cheryl
Bilhartz, Jacob
McKiernan, Patrick
Miloh, Tamir
Palle, Sirish
Kabbany, Mohammad Nasser
Munoz, Breda
Mospan, Andrea R.
Rudolph, Bryan
Xanthakos, Stavra A.
Vos, Miriam B.
author_sort Castillo-Leon, Eduardo
collection PubMed
description Background: Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health concern. Aminotransferase (ALT) is frequently used for screening and monitoring, but few studies have reported typical patterns of ALT elevation in children. Methods: TARGET-NASH is a real-world longitudinal observational cohort of patients with NAFLD receiving care across the United States. Analyses included children enrolled between 1 August 2016, and 12 October 2020, with at least one ALT measurement after enrollment. Peak ALT was based on the first and last available record and categorized into clinical cut points: <70 IU/L, >70–<250 IU/L, and >250 IU/L. A chi-squared test was used to compare differences in proportions, and a Kruskal–Wallis test was used to compare the medians and distributions of continuous responses. Results: Analyses included 660 children with a median age of 13 years. Of the 660, a total of 187 had undergone a biopsy and were more likely to be Hispanic or Latino (67% vs. 57%, p = 0.02) and to have cirrhosis (10% vs. 1%, p < 0.001). The highest ALT scores ranged from 28 U/L to 929 U/L; however, these scores varied across time. The prevalence of cirrhosis or any liver fibrosis stage was most common among children with a peak ALT > 70 U/L. Conclusions: Large variability was seen in ALT among children, including many values > 250 U/L. Higher levels of ALT were associated with increased prevalence of comorbidities and more advanced stages of NAFLD. These findings support an increased need for therapeutics and disease severity assessment in children with peak ALT > 70 U/L.
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spelling pubmed-89468832022-03-25 Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease Castillo-Leon, Eduardo Morris, Heather L. Schoen, Cheryl Bilhartz, Jacob McKiernan, Patrick Miloh, Tamir Palle, Sirish Kabbany, Mohammad Nasser Munoz, Breda Mospan, Andrea R. Rudolph, Bryan Xanthakos, Stavra A. Vos, Miriam B. Children (Basel) Article Background: Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health concern. Aminotransferase (ALT) is frequently used for screening and monitoring, but few studies have reported typical patterns of ALT elevation in children. Methods: TARGET-NASH is a real-world longitudinal observational cohort of patients with NAFLD receiving care across the United States. Analyses included children enrolled between 1 August 2016, and 12 October 2020, with at least one ALT measurement after enrollment. Peak ALT was based on the first and last available record and categorized into clinical cut points: <70 IU/L, >70–<250 IU/L, and >250 IU/L. A chi-squared test was used to compare differences in proportions, and a Kruskal–Wallis test was used to compare the medians and distributions of continuous responses. Results: Analyses included 660 children with a median age of 13 years. Of the 660, a total of 187 had undergone a biopsy and were more likely to be Hispanic or Latino (67% vs. 57%, p = 0.02) and to have cirrhosis (10% vs. 1%, p < 0.001). The highest ALT scores ranged from 28 U/L to 929 U/L; however, these scores varied across time. The prevalence of cirrhosis or any liver fibrosis stage was most common among children with a peak ALT > 70 U/L. Conclusions: Large variability was seen in ALT among children, including many values > 250 U/L. Higher levels of ALT were associated with increased prevalence of comorbidities and more advanced stages of NAFLD. These findings support an increased need for therapeutics and disease severity assessment in children with peak ALT > 70 U/L. MDPI 2022-03-08 /pmc/articles/PMC8946883/ /pubmed/35327746 http://dx.doi.org/10.3390/children9030374 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Castillo-Leon, Eduardo
Morris, Heather L.
Schoen, Cheryl
Bilhartz, Jacob
McKiernan, Patrick
Miloh, Tamir
Palle, Sirish
Kabbany, Mohammad Nasser
Munoz, Breda
Mospan, Andrea R.
Rudolph, Bryan
Xanthakos, Stavra A.
Vos, Miriam B.
Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title_full Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title_fullStr Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title_full_unstemmed Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title_short Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease
title_sort variation in alanine aminotransferase in children with non-alcoholic fatty liver disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946883/
https://www.ncbi.nlm.nih.gov/pubmed/35327746
http://dx.doi.org/10.3390/children9030374
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