The stratifiedwaist-height ratio (W/H ratio) and its association with hypertransaminasemia and hyperuricemia in children and adolescents with obesity
Paul Tadeo Ríos Gallardo1, Lilia Mayrel Santiago Lagunes1, Arturo Perea Martínez1, María De los Ángeles Hernández López1, Ariadna Guadalupe Lara Campos1, Aranza Lilian Perea Caballero1, Miriam Mercedes Padrón Martínez1, Ana Lidia González Valadez1, Verónica García Osorio1
1National Institute of Pediatrics, Clinical Obesity and Non Communicable disease, México, Mexico
Objectives and Study:
To determine the association of stratified waist-height ratio (W/H ratio) with hypertransaminasemia and hyperuricemia in children and adolescents with obesity. Descriptive, transversal, observational and retrospective study.
698 individuals between 5 and 18 years old were attended for the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any intercurrent pathology. The waist-height ratio (W/H ratio) was stratified at different parameters.
Aspartate aminotransferase (AST) >60 mg/dl, alanine aminotransferase (ALT) >25 mg/dl for boys and >22 mg/dl for girls, gamma-glutamyltransferase (GGT) >32 U/l for < 10 years old and > 24 U/l for >10 years old were defined as suggested by the National Health and Nutrition Examination Survey (NHANES). Hyperuricemia was defined as >5.5 mg/dl. Software IBM SPSS Statistics V.24.
Elevated ALT and GGT were the most frequent findings. From the W/H ratio stratum of 0.60 to 0.64 it is detected that high ALT is more frequent with a percentage of 65%, increasing the proportion resulting directly with the W/H ratio value reaching up to 79% in the stratum of 0.65. To 0.69. GGT was found to be elevated in more than 40% of the cases from the W/H ratio stratum of 0.55 to 0.59, maintaining an ascending value as the W/H ratio increased. Hyperuricemia was found in more than 50% of the cases in the strata of 0.60 to 0.64 and 0.65 to 0.69; however, the increase was not directly related to the value of W/H ratio of strata with higher value. Results reflect the high relationship between stratified W/H ratio with hypertransaminasemia and hyperuricemia; however, no strength of association that allows establishing that the higher the value of the ICE the prevalence of these anomalies be found high. It is important to note that the frequency with which the biochemical abnormalities were found had a considerable value without association with central obesity, which could suggest other factors as conditioning factors of these anomalies.
Non-alcoholic fatty liver disease (NAFLD) is an emerging health problem associated with childhood obesity and adult metabolic syndrome. Early NAFLD might progress to non-alcoholic steatohepatitis (NASH) or liver cirrhosis and significantly increase liver disease-related mortality. The W/H ratio has been proposed as a more reliable anthropometric index for detecting childhood obesity, body fat percentage, and also reported the effects of the W/H ratio on visceral fat and metabolic components in children and adolescents. The association between NAFLD and the W/H ratio was demonstrated in several studies. In the present study, the W/H ratio value above 0.50 as a concept of central obesity, relates in a general way to a higher possibility of presenting states of hypertransaminasemia andor hyperuricemia or not but does not exclude other causes that motivate these anomalies. The W/H ratio might be an important index of the severity of pediatric NAFLD.
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