Koutny, FlorianFlorianKoutnyWeghuber, DanielDanielWeghuberBollow, E.E.BollowGreber‐Platzer, S.S.Greber‐PlatzerHartmann, K.K.HartmannKörner, A.A.KörnerReinehr, T.T.ReinehrRoebl, M.M.RoeblSimic‐Schleicher, G.G.Simic‐SchleicherWabitsch, M.M.WabitschWidhalm, K.K.WidhalmWiegand, S.S.WiegandHoll, R. W.R. W.Holl2019-12-182021-10-272019-12-182021-10-2720192047-6302https://resolver.sub.uni-goettingen.de/purl?gro-2/92061BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes mellitus are known to be closely linked with obesity as early as during childhood. OBJECTIVES: The study aimed to determine the prevalence of prediabetes and T2DM in children with obesity with or without increased transaminases. METHODS: Data from the observational multicentre (n = 51), cross-sectional Adipositas Patienten Verlaufsbeobachtung registry were analyzed. Mild increase (mild group) was defined by alanine transaminase (ALT) >24 to ≤50 U/L and moderate to severe increase (advanced group) by ALT > 50 U/L. Prediabetes and T2DM were defined according to recent IDF/ISPAD guidelines. RESULTS: The prevalence of prediabetes and T2DM was 11.9% (95% CI: 11.0-12.8) and 1.4% (95% CI: 1.1-1.7) among all participants (n = 4932; male = 2481; mean age 12.9 ± 2.7 years; BMI-SDS 2.1 ± 0.5; Tanner stage 3.2 ± 1.5). The prevalence of impaired glucose metabolism (prediabetes and T2DM) was 13.8% (95% CI: 12.1-15.4) in the mild, 21.9% (95% CI: 18.8-25.1) in the advanced group, 10.7% (95% CI: 9.4-11.9) in the control group. Mild and advanced groups had greater odds ratios for prediabetes [1.42; 95% CI: 1.17-1.72, 2.26-fold; (1.78-2.86), respectively], the advanced group also for T2DM [2.39 (1.36-4.21)] compared to controls. While an increase in transaminases predominantly affected boys, girls within the advanced group had a higher T2DM prevalence than males (5.4 vs. male 2.1%). CONCLUSIONS: Children with obesity and increased liver transaminases as surrogates of NAFLD should be screened for T2DM.enCC BY-NC 4.0https://creativecommons.org/licenses/by-nc/4.0610journal_article10.1111/ijpo.12601318101102047-6310https://resolver.sub.uni-goettingen.de/purl?gs-1/17030