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Normal serum alanine aminotransferase and non-alcoholic fatty liver disease among Korean adolescents: a cross-sectional study using data from KNHANES 2010-2015

 Yunkoo Kang  ;  Sowon Park  ;  Seung Kim  ;  Hong Koh 
 BMC PEDIATRICS, Vol.18(1) : 215, 2018 
Journal Title
Issue Date
Alanine aminotransferase ; Korea ; Non-alcoholic fatty liver disease ; Upper normal limit
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is complicated disease and increasing worldwide. Previously, many studies of NALFD prevalences have used alanine aminotransferase (ALT) of > 40 U/L to define NAFLD, although that is too high to be reliable among adolescents. This study aimed to define the upper normal limit of ALT among Korean adolescents, and use it to estimate the prevalence of NAFLD, based on data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: Data were obtained from 1785 healthy adolescents (916 boys and 869 girls, 10-18 years old) who participated in the KNHANES during 2010-2015. The International Diabetes Federation metabolic syndrome criteria for adolescents were used to exclude participants with metabolic syndrome components. Furthermore, participants who previously had diseases related to low HDL levels, high TG levels, diabetes, or very low/high body mass index and hepatitis B were excluded. The 95th percentiles level of ALT from healthy participants were evaluated. The definition of NAFLD was overweight status (>/=85th percentile of body mass index) plus elevated ALT levels (95th percentile). RESULTS: The upper normal ALT were 24.1 U/L for boys and 17.7 U/L for girls. Based on these values, the estimated prevalences of NAFLD in 2015 were 8.9% among adolescents. CONCLUSION: Defining the upper normal limit of ALT can be adjusted for each sex and ethnics in the general population. ALT laboratory thresholds used for children should be re-examined. The physicians should be aware not to underdiagnose NAFLD patient even ALT level is < 40 U/L.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yunkoo(강윤구) ORCID logo https://orcid.org/0000-0003-1712-2138
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Park, So Won(박소원) ORCID logo https://orcid.org/0000-0002-2498-8004
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