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Background <p>The critical age window during which early-life adiposity impacts liver health remains unclear. This study aimed to identify the timing of adiposity gain associated with elevated alanine aminotransferase (ALT) levels in 8-year-old children.</p> Methods <p>This prospective cohort study included 1322 children (665 boys; mean age 96.2 ± 3.4&#xa0;months) from a subset of the Japan Environment and Children’s Study. Anthropometric data were collected at birth and at 1, 2, 3, 4, 5, 6, and 8&#xa0;years. Adiposity gain was assessed using conditional weight, a residual-based metric adjusted for prior weight and current height. Excess adiposity was defined as conditional weight above the 90th percentile. ALT was measured at age 8, with elevation defined as &gt; 26&#xa0;IU/L in boys and &gt; 22&#xa0;IU/L in girls. Multivariable regression models were adjusted for maternal, perinatal, and early-life factors.</p> Results <p>ALT elevation was observed in 3.3% of the children. Adiposity gain was significantly associated with higher ALT concentrations, beginning at age 3 in girls (adjusted coefficient: 0.11, <i>p</i> &lt; 0.01) and at age 4 in boys (adjusted coefficient: 0.10, <i>p</i> &lt; 0.05). The 4–5-year interval marked the earliest period of notable risk, with adjusted risk ratios (95% CI) of 4.18 (1.77–9.87) in boys and 3.29 (1.04–10.40) in girls. Birth weight and adiposity during infancy were not consistently associated with ALT concentrations.</p> Conclusions <p>Early childhood—particularly between ages 3 and 5&#xa0;years—may represent a period during which associations between excess adiposity gain and later liver health become detectable. Because liver enzymes were assessed at a single time point, the temporal onset of these associations cannot be established. These findings should be interpreted cautiously and warrant confirmation using longitudinal assessments of liver health.</p> Graphical Abstract <p></p>

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Early childhood weight gain and alanine aminotransferase at age 8: an adjunct study of the Japan Environment and Children’s Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月3日

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  • Naw Awn J-P,
  • Keiko Yamasaki,
  • Naomi Mitsuda,
  • Masamitsu Eitoku,
  • Ryuhei Nagai,
  • Mariko Araki,
  • Mariko Taniguchi-Ikeda,
  • Narufumi Suganuma

摘要

Background

The critical age window during which early-life adiposity impacts liver health remains unclear. This study aimed to identify the timing of adiposity gain associated with elevated alanine aminotransferase (ALT) levels in 8-year-old children.

Methods

This prospective cohort study included 1322 children (665 boys; mean age 96.2 ± 3.4 months) from a subset of the Japan Environment and Children’s Study. Anthropometric data were collected at birth and at 1, 2, 3, 4, 5, 6, and 8 years. Adiposity gain was assessed using conditional weight, a residual-based metric adjusted for prior weight and current height. Excess adiposity was defined as conditional weight above the 90th percentile. ALT was measured at age 8, with elevation defined as > 26 IU/L in boys and > 22 IU/L in girls. Multivariable regression models were adjusted for maternal, perinatal, and early-life factors.

Results

ALT elevation was observed in 3.3% of the children. Adiposity gain was significantly associated with higher ALT concentrations, beginning at age 3 in girls (adjusted coefficient: 0.11, p < 0.01) and at age 4 in boys (adjusted coefficient: 0.10, p < 0.05). The 4–5-year interval marked the earliest period of notable risk, with adjusted risk ratios (95% CI) of 4.18 (1.77–9.87) in boys and 3.29 (1.04–10.40) in girls. Birth weight and adiposity during infancy were not consistently associated with ALT concentrations.

Conclusions

Early childhood—particularly between ages 3 and 5 years—may represent a period during which associations between excess adiposity gain and later liver health become detectable. Because liver enzymes were assessed at a single time point, the temporal onset of these associations cannot be established. These findings should be interpreted cautiously and warrant confirmation using longitudinal assessments of liver health.

Graphical Abstract