HEPATIC STEATOSIS AS DIABETES TYPE 2 PREDICTOR

Non alcoholic fatty liver disease (NAFLD) is associated with obesity, insulin resistance (IR) and increased type 2 diabetes (T2D). Alanine aminotransferase (ALT) is recognized as biochemical marker of NAFLD, currently used as screening for this disease. Objective: To estimate the associations between (ALT) with anthropometric variables, insulin resistance and inflamatory markers in pediatric population. Patients and Method: we studied 348 subjects (52.7% females), aged between 4.9 and 15.6 years. Blood samples for measuring: AST, ALT, glycaemia, insulin, lipid profile, hsCRP TNF-alpha, IL-6 and adiponectin. We calculate HOMA-IR, QUICKI y el HOMA-beta. The results are expressed are expressed as median interquartile range. Variables were log10 transformed before Pearson correlations analyze. Results: Serum ALT levels were positively associated with BMI-SDS (r = 0.335), waist/height ratio (r = 0.358), insulin (r = 0.33), HOMA-IR (r = 0.33), HOMA-beta (r = 0.26), TG/HDL-c (r = 0.2), hsCRP (r = 0.3); and a negative association with QUICKI (r = -0.25) and adiponectin (r = -0.113). Non-association with ALT, glycaemia, TNF-a and IL-6 was found. Conclusion: Our study demonstrated that ALT, but not AST, was significantly correlated with of insulin resistance and inflamatory markers, all of them recognized as risk parameters of pre diabetes stage. ALT should be part of the evaluation of all obesity children, mainly those with other cardiometabolic risk factors, since it could predict later development of T2DM. Further imaging studies are necessary to confirm fatty liver disease in this population.