(P10-013-24) Prenatal and Early Childhood Lifestyle Factors Associated With Liver Injury Biomarkers in School-Aged Children From the PROGRESS Cohort in Mexico City

Objectives: To identify prenatal and early childhood lifestyle factors associated with liver injury biomarkers (serum ALT: Alanine Aminotransferase, AST: Aspartate Aminotransferase, and GGT: Gamma Glutamyl Transferase) in school-aged children.

Methods: We studied 178 children from the Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) birth cohort in Mexico. Factors examined included maternal age in pregnancy and pre-pregnancy body mass index (BMI), and childhood (4 years follow-up) physical activity (PA), sedentary time (ST), soft drink intake (SDI), and waist circumference (WC). Fasting serum samples collected at school-age (8 to 12 years) were used to measure the concentration of liver injury biomarkers. Linear regression models estimated the association (β, 95% CIs) between prenatal and early childhood factors with ALT, AST or GGT (log-transformed) levels, adjusting for confounders. We also conducted stratified analysis by sex and tested for interaction.

Results: Children had on average 9 years old, and 51% were males., 10% presented elevated levels for ALT (boys: ≥25.8 U/L, girls: ≥22.1 U/L), 64% for AST (boys: ≥23 U/L, girls: ≥20 U/L) and 6% for GGT (boys and girls: ≥24 U/L), respectively. Children at the 3rd tertile of ST had 27.6% [(95% CI: 2.9, 58.3) p=0.027] higher ALT and 12.5% [(95% CI: 0.5, 25.8) p=0.040] higher AST levels compared to those at the 1st tertile. Additionally, for each 100 ml increase in SDI, ALT levels increased by 16.6% [β=16.6% (95% CI: 4.2, 30.5) p=0.008] and AST levels increased 8.5% [(95% CI: 2.4, 15.1) p=0.007]. Finally, for each 1 cm increase in WC, ALT levels increased by 16.6% [(95% CI: 4.2, 30.5) p=0.008], and GGT levels increased by 1.9% [(95% CI: 0.4, 3.3) p=0.012] at childhood-aged. Children of mothers with obesity had 23.8% (95% CI: 4.6, 46.5) p=0.013] higher GGT levels compared to children of mothers with normal BMIs. We observed an interaction by sex (p-interaction=0.069) only in the association between SDI and ALT levels, with a stronger association in boys [β=28.7% (95% CI: 10.5, 49.9) p=0.001] compared to girls [β=4.6% (95% CI: -12.2, 24.6) p=0.612].

Conclusions: Maternal pre-pregnancy obesity and childhood ST and SDI are important risk factors for liver injury at school-aged in Mexican children that are preventable and modifiable.

Funding Sources: NIEHS P30ES023515, main project: R01ES013744