Journal of pediatric gastroenterology and nutrition · 2025
Ability of triglyceride-glucose indices to predict metabolic dysfunction associated with steatotic liver disease in pediatric obesity.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Di Bonito Procolo, Di Sessa Anna, Licenziati Maria Rosaria, Corica Domenico, Wasniewska Małgorzata Gabriela, Morandi Anita, Maffeis Claudio, Faienza Maria Felicia, Mozzillo Enza, Calcaterra Valeria, Franco Francesca, Maltoni Giulio, Miraglia Del Giudice Emanuele, Umano Giuseppina Rosaria, Valerio Giuliana
Аннотация
OBJECTIVES: We aimed to evaluate the best cut-off of alanine aminotransferase (ALT) to predict the metabolic dysfunction-associated steatotic liver disease (MASLD) in youths with overweight/obesity (OW/OB) and analyze the performance of the triglyceride-glucose index (TyG) or its association with anthropometric variables compared to ALT.
METHODS: This multicenter, cross-sectional study analyzed data of 2813 youths (1463 boys and 1350 girls) aged 6-17 years recruited in 10 Italian centers for the management of pediatric OB. Exclusion criteria were: body mass index (BMI) Z-score >5, diabetes, secondary obesity, triglycerides (TG) ≥ 400 mg/dL. MASLD was defined on the presence of hepatic steatosis at abdominal ultrasound, in combination with at least one cardiometabolic risk factor. The performance of ALT and TyG-derived indices for MASLD diagnosis was assessed using the receiver operation curve and the area under the curve (AUC) with the 95% confidence intervals were obtained.
RESULTS: MASLD was observed in 1278 youths (45.1%). The global AUC of ALT was 0.661 (0.641-0.682), p < 0.0001. Using Youden's index the best cut-off of ALT was ≥26 IU/L in boys and ≥22 IU/L in girls. The AUCs of TyG-BMI, TyG-WC, and TyG-ALT were 0.678 (0.659-0.698), 0.659 (0.639-0.679), and 0.666 (0.645-0.686), respectively. Using Delong's test none TyG-derived index showed a better performance than ALT alone.
CONCLUSIONS: This study demonstrates that the values of ALT ≥ 26 IU/L in boys and ≥22 IU/L in girls can be used for the screening of MASLD in youths with OW/OB, while the combination of TyG-derived indices is not superior to ALT alone.
METHODS: This multicenter, cross-sectional study analyzed data of 2813 youths (1463 boys and 1350 girls) aged 6-17 years recruited in 10 Italian centers for the management of pediatric OB. Exclusion criteria were: body mass index (BMI) Z-score >5, diabetes, secondary obesity, triglycerides (TG) ≥ 400 mg/dL. MASLD was defined on the presence of hepatic steatosis at abdominal ultrasound, in combination with at least one cardiometabolic risk factor. The performance of ALT and TyG-derived indices for MASLD diagnosis was assessed using the receiver operation curve and the area under the curve (AUC) with the 95% confidence intervals were obtained.
RESULTS: MASLD was observed in 1278 youths (45.1%). The global AUC of ALT was 0.661 (0.641-0.682), p < 0.0001. Using Youden's index the best cut-off of ALT was ≥26 IU/L in boys and ≥22 IU/L in girls. The AUCs of TyG-BMI, TyG-WC, and TyG-ALT were 0.678 (0.659-0.698), 0.659 (0.639-0.679), and 0.666 (0.645-0.686), respectively. Using Delong's test none TyG-derived index showed a better performance than ALT alone.
CONCLUSIONS: This study demonstrates that the values of ALT ≥ 26 IU/L in boys and ≥22 IU/L in girls can be used for the screening of MASLD in youths with OW/OB, while the combination of TyG-derived indices is not superior to ALT alone.