Association of Elevated Liver Enzymes with Non-Invasive Risk Factors for Type II Diabetes Mellitus in Children

Purpose: The obesity epidemic has led to an increased incidence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) in children. This relationship is significant as the liver is intimately involved in blood glucose homeostasis as insulin resistance triggers glycogenolysis in the liver. However, there is limited research on the association between elevated liver enzymes and risk factors for T2DM in children. The purpose of this study was to assess the prevalence of elevated liver enzymes and their association with non-invasive risk factors for T2DM in non-diabetic children between the ages of 10-14 years without chronic diseases. The liver enzymes studied were alkaline phosphatase (ALP), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (GGT). The non-invasive risk factors for T2DM are 1) Body Mass Index (BMI) [greater than] 85th percentile for age and gender, 2) blood pressure [greater than] 95th percentile for height and gender, 3) acanthosis nigricans, 4) race or ethnicity of high risk, and 5) history of T2DM in the family. A race or ethnicity of high risk includes African Americans, Hispanics, American Indians, and Asian/Pacific Islanders. Methods: Following IRB approval, the study was conducted at the outpatient clinics of the University of North Texas Health Science Center, Fort Worth. Children with elevated blood glucose levels, chronic medical conditions, or those who had received systemic corticosteroid therapy within the last year were excluded. Participation was voluntary and 151 children participated in the study who were from the representative races and ethnicities attending the clinics. Results: Results indicated that those with elevated GGT levels had marginally higher BMI (p=0.06) and were significantly more likely to have acanthosis nigricans (p Conclusions: These results suggest that there are meaningful relationships between elevated liver enzymes and non-invasive risk factors for T2DM.