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Hb and dyslipidaemia as predicting markers of serum alanine aminotransferase elevation in Chinese adolescents

  • Kuo-Ching Chao (a1) (a2), Chun-Chao Chang (a1) (a2), Eddy Owaga (a3), Chyi-Huey Bai (a4), Tzu-chieh Huang (a5), Wen-Harn Pan (a6) (a7) and Jung-Su Chang (a5)...

Abstract

Objective

Fe is an essential element for erythropoiesis and Hb synthesis. High Hb levels affect the blood’s viscosity and are associated with cardiovascular dysfunction. The aim of the present study was to examine relationships of Hb and cardiometabolic abnormalities with the risk of alanine aminotransferase (ALT) elevation in adolescents.

Design

A population-based, cross-sectional study.

Setting

National Nutrition and Health Survey in Taiwan (2010–2011, adolescents).

Subjects

Healthy adolescents aged 13–18 years.

Results

In total, 1941 adolescents (963 boys and 978 girls) were entered in the study. The mean age was 15·3 (sd 0·1) years (boys, 15·3 (sd 0·1) years; girls, 15·2 (sd 0·1) years). ALT tertile cut-off points for boys were 11 and 16 U/l, and for girls were 9 and 12 U/l. Girls without dyslipidaemia and presenting in the highest quartile (Q1) of Hb (>13·6 g/dl) were 1·89 and 3·76 times more likely to have raised serum ALT (9 and >12 U/l, respectively) than the reference (lowest quartile of Hb (Q1), <12·4 g/dl). Moreover, for those girls with dyslipidaemia, serum ALT seemed to increase with an increase in Hb levels. Specifically, girls with dyslipidaemia and Hb levels of 12·4, 13·1 and 13·6 g/dl were, respectively, 2·86, 3·53 and 5·64 times more likely to have elevated serum ALT levels (>12 U/l) than the reference (Q1 of Hb, <12·4 g/dl). The only effect found in boys was for those who had dyslipidaemia and presenting in Q4 of Hb (>15·4 g/dl), who were 7·40 times more likely to have elevated serum ALT of >16 U/l than the reference (Q1 of Hb, <14·1 g/dl).

Conclusions

Our findings suggest that an increased Hb level is a predictor of elevated serum ALT in adolescent girls with dyslipidaemia. Our study also highlights the importance of further research to establish cut-off points for Hb and its utility in diagnosing and preventing the onset of dyslipidaemia in adolescents.

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Copyright

Corresponding author

* Corresponding author: Email susanchang@tmu.edu.tw

References

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1. Welsh, JA, Karpen, S & Vos, MB (2013) Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988–1994 to 2007–2010. J Pediatr 162, 496500.
2. Park, JH, Kim, SH, Park, S et al. (2014) Alanine aminotransferase and metabolic syndrome in adolescents: the Korean National Health and Nutrition Examination Survey Study. Pediatr Obes 9, 411418.
3. Fu, CC, Chen, MC, Li, YM et al. (2009) The risk factors for ultrasound-diagnosed non-alcoholic fatty liver disease among adolescents. Ann Acad Med Singapore 38, 1517.
4. Di Bonito, P, Sanguigno, E, Di Fraia, T et al. (2009) Association of elevated serum alanine aminotransferase with metabolic factors in obese children: sex-related analysis. Metabolism 58, 368372.
5. Park, HS, Han, JH, Choi, KM et al. (2005) Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. Am J Clin Nutr 82, 10461051.
6. Liu, Z, Que, S, Ning, H et al. (2013) Elevated alanine aminotransferase is strongly associated with incident metabolic syndrome: a meta-analysis of prospective studies. PLoS One 8, e80596.
7. Adams, LA, Angulo, P & Lindor, KD (2005) Nonalcoholic fatty liver disease. CMAJ 172, 899905.
8. Song, HR, Yun, KE & Park, HS (2008) Relation between alanine aminotransferase concentrations and visceral fat accumulation among nondiabetic overweight Korean women. Am J Clin Nutr 88, 1621.
9. Ayonrinde, OT, Olynyk, JK, Beilin, LJ et al. (2011) Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology 53, 800809.
10. Kunutsor, SK, Apekey, TA & Walley, J (2013) Liver aminotransferases and risk of incident type 2 diabetes: a systematic review and meta-analysis. Am J Epidemiol 178, 159171.
11. Wang, CS, Chang, TT, Yao, WJ et al. (2012) Impact of increasing alanine aminotransferase levels within normal range on incident diabetes. J Formos Med Assoc 111, 201208.
12. Deugnier, YM, Loreal, O, Turlin, B et al. (1992) Liver pathology in genetic hemochromatosis: a review of 135 homozygous cases and their bioclinical correlations. Gastroenterology 102, 20502059.
13. Riva, A, Trombini, P, Mariani, R et al. (2008) Revaluation of clinical and histological criteria for diagnosis of dysmetabolic iron overload syndrome. World J Gastroenterol 14, 47454752.
14. Dongiovanni, P, Fracanzani, AL, Fargion, S et al. (2011) Iron in fatty liver and in the metabolic syndrome: a promising therapeutic target. J Hepatol 55, 920932.
15. Bai, CH, Owaga, E, Cheng, SY et al. (2014) Relationship between hemoglobin levels and risk for suspected non-alcoholic fatty liver in Taiwanese adults. Chin J Physiol 57, 286294.
16. Yu, C, Xu, C, Xu, L et al. (2012) Serum proteomic analysis revealed diagnostic value of hemoglobin for nonalcoholic fatty liver disease. J Hepatol 56, 241247.
17. Chang, JS, Li, YL, Lu, CH et al. (2014) Interleukin-10 as a potential regulator of hepcidin homeostasis in overweight and obese children: a cross-sectional study in Taiwan. Nutrition 30, 11651170.
18. Yilmaz, Y, Senates, E, Ayyildiz, T et al. (2012) Characterization of nonalcoholic fatty liver disease unrelated to the metabolic syndrome. Eur J Clin Invest 42, 411418.
19. Mitsuyoshi, H, Yasui, K, Harano, Y et al. (2009) Analysis of hepatic genes involved in the metabolism of fatty acids and iron in nonalcoholic fatty liver disease. Hepatol Res 39, 366373.
20. Metivier, F, Marchais, SJ, Guerin, AP et al. (2000) Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dial Transplant 15, Suppl. 3, 1418.
21. Pan, WH, Lee, MS, Chuang, SY et al. (2008) Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev 9, Suppl. 1, 2231.
22. Tan, CE, Ma, S, Wai, D et al. (2004) Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 27, 11821186.
23. Kimura, Y, Hyogo, H, Yamagishi, S et al. (2010) Atorvastatin decreases serum levels of advanced glycation endproducts (AGEs) in nonalcoholic steatohepatitis (NASH) patients with dyslipidemia: clinical usefulness of AGEs as a biomarker for the attenuation of NASH. J Gastroenterol 45, 750757.
24. Moy, KA, Jiao, L, Freedman, ND et al. (2013) Soluble receptor for advanced glycation end products and risk of liver cancer. Hepatology 57, 23382345.
25. Detivaud, L, Nemeth, E, Boudjema, K et al. (2005) Hepcidin levels in humans are correlated with hepatic iron stores, hemoglobin levels, and hepatic function. Blood 106, 746748.
26. Chang, JS, Chen, YC, Owaga, E et al. (2014) Interactive effects of dietary fat/carbohydrate ratio and body mass index on iron deficiency anemia among Taiwanese women. Nutrients 6, 39293941.
27. Estevez, M (2011) Protein carbonyls in meat systems: a review. Meat Sci 89, 259279.
28. Fu, MX, Requena, JR, Jenkins, AJ et al. (1996) The advanced glycation end product, N ε-(carboxymethyl)lysine, is a product of both lipid peroxidation and glycoxidation reactions. J Biol Chem 271, 99829986.
29. Christman, AL, Lazo, M, Clark, JM et al. (2011) Low glycated hemoglobin and liver disease in the US population. Diabetes Care 34, 25482550.
30. Basta, G, Navarra, T, De Simone, P et al. (2011) What is the role of the receptor for advanced glycation end products–ligand axis in liver injury? Liver Transpl 17, 633640.
31. Hou, Y, Zhang, S, Wang, L et al. (2012) Estrogen regulates iron homeostasis through governing hepatic hepcidin expression via an estrogen response element. Gene 511, 398403.
32. Cho, BH, Smith, TL, Park, JR et al. (1988) Effects of estrogen-induced hyperlipidemia on the erythrocyte membrane in chicks. Lipids 23, 853856.
33. Le Petit-Thevenin, J, Lerique, B, Nobili, O et al. (1991) Estrogen modulates phospholipid acylation in red blood cells: relationship to cell aging. Am J Physiol 261, C423C427.
34. Owen, JS, Bruckdorfer, KR, Day, RC et al. (1982) Decreased erythrocyte membrane fluidity and altered lipid composition in human liver disease. J Lipid Res 23, 124132.
35. Jiang, Y, Zeng, J & Chen, B (2014) Hemoglobin combined with triglyceride and ferritin in predicting non-alcoholic fatty liver. J Gastroenterol Hepatol 29, 15081514.
36. Wu, TW, Lin, HH & Wang, LY (2013) Chronic hepatitis B infection in adolescents who received primary infantile vaccination. Hepatology 57, 3745.

Keywords

Hb and dyslipidaemia as predicting markers of serum alanine aminotransferase elevation in Chinese adolescents

  • Kuo-Ching Chao (a1) (a2), Chun-Chao Chang (a1) (a2), Eddy Owaga (a3), Chyi-Huey Bai (a4), Tzu-chieh Huang (a5), Wen-Harn Pan (a6) (a7) and Jung-Su Chang (a5)...

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