Children and young people (CYP) with abnormal liver function tests, especially when associated with obesity, have an increased chance of developing liver disease in adulthood. A retrospective cross-sectional population study determined whether obesity and metabolic risk factors can be utilized to predict liver function testing and abnormal liver test results in CYP.

The study utilized the data of 257,746 CYP aged 10 to 25 years. Demographic, clinical data and serum alanine aminotransferase (ALT) test results were taken into consideration. 

BMI category thresholds were customized according to age group and ethnicity.

The following observations were made-

• Of 14% of CYP, who had ALT measured, 5.4% reported abnormal results; 36.3% reported BMI indicating overweight or obesity. 
• The most frequent diagnosis was Nonalcoholic fatty liver disease. 
• Multivariate analyses proved overweight or obesity to be an independent predictor of ALT testing in young people (ages 18-25), sparing children (ages 10-17).
• Overweight or obesity also came out to be an independent predictor of abnormal test results in all CYP, irrespective of ALT threshold, by Multivariate analyses.

Thus overweight and obesity were inferred to be the predictors of liver testing (not in children) and abnormal test results, independent of the ALT threshold. 

A coordinated strategy is needed for liver testing and interpreting results in this young population as the prevalence of metabolic dysfunction is rapidly increasing.

Source: Li W, Homer K, Hull S, Boomla K, Robson J, Alazawi W. Obesity Predicts Liver Function Testing and Abnormal Liver Results. Obesity,2020;28(1):132-138