Background The associations of renal, hepatic, and hematologic markers with metabolic risk (MR) have already been shown in adolescents. However, it is still controversial which marker best predicts metabolic changes in youth. The aim of this study was to verify the association of MR with alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid, and hemoglobin (Hb) in adolescents. Methods We evaluated 1713 Brazilian adolescents aged 10 to 17 years. MR was calculated using a continuous metabolic risk score, including the sum of Z -scores of waist circumference, systolic blood pressure, fasting glucose, high-density lipoproteins, triglycerides, and cardiorespiratory fitness. Cutoff points were set for MR prediction for five metabolic components (ALT, AST, AST/ALT ratio, uric acid, and Hb). Results MR was strongly associated with increased uric acid (odds ratio [OR]: 2.50; 95% confidence interval [CI]: 1.74–3.59), ALT (OR: 2.64; 95% CI: 1.63–4.27), and AST levels (OR: 2.53; 95% CI: 1.24–5.18). Uric acid was shown to be the best predictor for MR (sensitivity: 55.79%; specificity: 61.35%; area under the curve: 0.616). Conclusion Elevated hepatic, renal, and hematological markers were associated with MR in adolescents, especially ALT, AST, and uric acid levels. Impact Elevated hepatic, renal, and hematological markers were associated with metabolic risk in adolescents, especially ALT, AST, and uric acid levels. It is still controversial which marker best predicts metabolic changes in adolescents. In addition, association of Hb with metabolic risk is under-studied in this population. It is important to further investigate the relationship between elevated Hb and hepatic markers, since there are key aspects not addressed yet. Our results highlight the importance of creating public health policies aimed to child and adolescent population, to prevention of metabolic disorders from an early age.

中文翻译：

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与青少年肝酶、尿酸和血红蛋白相关的代谢风险

背景 肾脏、肝脏和血液学标志物与代谢风险 (MR) 的关联已经在青少年中得到证实。然而，哪种标记最能预测青年的代谢变化仍然存在争议。本研究的目的是验证 MR 与青少年丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)、尿酸和血红蛋白 (Hb) 的关联。方法 我们评估了 1713 名 10 至 17 岁的巴西青少年。MR 是使用连续代谢风险评分计算的，包括腰围、收缩压、空腹血糖、高密度脂蛋白、甘油三酯和心肺健康的 Z 评分的总和。为 MR 预测设置了五种代谢成分（ALT、AST、AST/ALT 比率、尿酸和 Hb）的截止点。结果 MR 与尿酸升高（优势比 [OR]：2.50；95% 置信区间 [CI]：1.74–3.59）、ALT（OR：2.64；95% CI：1.63–4.27）和 AST 水平（或：2.53；95% 置信区间：1.24–5.18）。尿酸被证明是 MR 的最佳预测指标（敏感性：55.79%；特异性：61.35%；曲线下面积：0.616）。结论 肝脏、肾脏和血液学指标升高与青少年 MR 相关，尤其是 ALT、AST 和尿酸水平。影响 肝脏、肾脏和血液学标志物升高与青少年的代谢风险有关，尤其是 ALT、AST 和尿酸水平。哪种标记最能预测青少年的代谢变化仍然存在争议。此外，在这一人群中，Hb 与代谢风险的相关性研究不足。进一步研究 Hb 升高与肝脏标志物之间的关系很重要，因为还有一些关键方面尚未解决。我们的研究结果强调了制定针对儿童和青少年人群的公共卫生政策的重要性，以从早期预防代谢紊乱。