The following is a summary of “Prevalence of Elevated ALT in Adolescents in the U.S. 2011–2018,” published in the July 2023 issue of Pediatrics by Mischel, et al.
For a study, researchers sought to investigate suspected nonalcoholic fatty liver disease (NAFLD) using elevated alanine aminotransferase (ALT) levels in a diverse and nationally representative cohort of adolescents and to characterize higher ALT elevation in adolescents with obesity.
Data from the National Health and Nutrition Examination Survey 2011–2018 were analyzed, focusing on adolescents aged 12–19 years. Participants with reasons for elevated ALT unrelated to NAFLD were excluded from the analysis. The study examined race and ethnicity, sex, body mass index (BMI), and ALT levels. Elevated ALT was defined as ALT levels exceeding >22 U/L for females and >26 U/L for males, using the upper normal limit (ULN) set by biological standards. Various thresholds of elevated ALT up to 2 times the ULN were also examined among adolescents with obesity. Multivariable logistic regression was employed to assess the association of race/ethnicity with elevated ALT, adjusting for age, sex, and BMI.
Elevated ALT in adolescents was 16.5%, with a significantly higher prevalence of 39.5% among those with obesity. Specifically, prevalence rates for White, Hispanic, and Asian adolescents were 15.8%, 21.8%, and 16.5% overall, 12.8%, 17.7%, and 27.0% in those with overweight, and 43.0%, 43.5%, and 43.1% in those with obesity, respectively. Notably, the prevalence was lower in Black adolescents, with rates of 10.7% overall, 8.4% for overweight, and 20.7% for obesity. Additionally, the prevalence of ALT at 2 times the ULN was 6.6% among adolescents with obesity. Hispanic ethnicity, age, male sex, and higher BMI were identified as independent predictors of elevated ALT.
The prevalence of elevated ALT in U.S. adolescents was considerably high, affecting approximately 1 in 6 adolescents from 2011 to 2018. The risk of elevated ALT is notably higher in Hispanic adolescents. Furthermore, Asian adolescents with elevated BMI may represent an emerging risk group for elevated ALT.
Source: journals.lww.com/jpgn/Abstract/2023/07000/Prevalence_of_Elevated_ALT_in_Adolescents_in_the.16.aspx