Screening for elevated serum alanine aminotransferase (ALAT) can help identifying individuals at the risks of chronic and metabolic diseases, but blood collection is invasive and cannot be widely used for investigations. Considered as simple and inexpensive screening indices, individual characteristics and anthropometric measurements can be measured in a large crowd and may be important surrogate markers for ALAT levels. This study aimed to examine the diagnostic performance of individual characteristics and anthropometric parameters as predictive factors for discerning an elevated ALAT activity among Shenzhen children and adolescents. A school-based screening study was performed from 9 high schools in Shenzhen during February 2017 and June 2018. Receiver operating characteristic curve was used to examine the diagnostic performance of each variable for detecting elevated ALAT. Altogether 7271 students aged 9–17 years were involved. The proportion of elevated ALAT greatly increased with increasing classification of BMI-z. By the sex-specific cut-offs for elevated ALAT (30 U/L boys; 19 U/L girls), BMI showed the highest area under the curve of 0.789 (95% CI 0.765–0.812) and followed by weight (0.779 [0.755–0.802]), BMI-z (0.747 [0.722–0.772]), height (0.622 [0.597–0.647]), and age (0.608 [0.584–0.632]), while height-z was not capable. With the cut-off of 67.8 kg for weight and 22.6 kg/m2 for BMI, the accuracy to identify elevated ALAT was 87.1% for weight and 82.9% for BMI. The presence of elevated ALAT was more common in overweight or obese children and adolescents. BMI and weight had the superiority of detecting elevated ALAT, followed by BMI-z, height, and age.

中文翻译：

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个体特征和人体测量学对儿童和青少年血清丙氨酸氨基转移酶升高的诊断性能

筛查血清丙氨酸氨基转移酶（ALAT）升高可以帮助识别处于慢性和代谢性疾病风险的个体，但是采血是侵入性的，不能广泛用于研究。被认为是简单且廉价的筛查指标，可以在大量人群中测量个体特征和人体测量学，并且可能是ALAT水平的重要替代指标。本研究旨在检查个体特征和人体测量学参数的诊断性能，作为识别深圳儿童和青少年ALAT活性升高的预测因素。在2017年2月至2018年6月期间，对深圳的9所中学进行了基于学校的筛选研究。接收器工作特性曲线用于检查每个变量检测ALAT升高的诊断性能。共有7271名9-17岁的学生参与其中。随着BMI-z分类的增加，ALAT升高的比例大大增加。根据升高的ALAT（30 U / L男孩； 19 U / L女孩）的性别特定阈值，BMI显示曲线下面积最高，为0.789（95％CI 0.765-0.812），其次是体重（0.779 [ 0.755–0.802]），BMI-z（0.747 [0.722-0.772]），身高（0.622 [0.597-0.647]）和年龄（0.608 [0.584-0.632]），而身高-z无法。由于体重的临界值是67.8 kg，BMI的临界值是22.6 kg / m2，因此识别出体重升高的ALAT的准确度为87.1％，BMI为82.9％。超重或肥胖的儿童和青少年中ALAT升高的情况更为常见。