Background and aims Metabolic risk leads to severe comorbidities in obesity. We evaluate the relationship between the values of gamma-glutamyl trans peptidase (GGT), a marker of hepatic involvement, and cardio metabolic risk factors in obese children.

Methods A prospective cross-sectional study of 147 children (aged 7 to 16 years) was carried out. Ninety-five children were obese with a body mass index standard deviation score (SDS-BMI) >2 and 52 children were normal weight. Patients with endocrine disease or syndromic obesity were excluded. We have analysed clinical parameters of adiposity (fat mass by bioelectrical impedance, waist and hip circumference), blood pressure, and classical biochemical parameters indicative of metabolic risk (lipid profile, glucose and insulin). Additionally, novel parameters related to metabolic risk such as uric acid, retinol binding protein (RBP4), cystatinC, homocysteine, thyrotropin, ultrasensitive C-reactive protein (CRP) and GGTwere also determined. Statistical analysis was made ANCOVA test and Pearson partial correlation adjusting for gender, age, Tanner stage, and BMI.

Results GGT was higher in the children with SDS-BMI >4 with respect children with SDS-BMI between 2 and 4(16.3 ± 5.8 vs 18.4 ± 8.8 IU/L, p = 0.025). Both groups were statistically significant with respect normal weight (12.2 ± 2.9 IU/L, p < 0.0001 and p < 0.001 respectively). GGT was correlated with SDS-BMI (p < 0.0001), waist circumference (p < 0.001), percentage of fat mass (p < 0.01), SDS of systolic blood pressure (p < 0.010), total cholesterol (p < 0.0001), LDL cholesterol (p < 0.0001), triglycerides (p < 0.0001), RBP4 (p < 0.047), thyrotropin (p < 0.019) and CRP (p < 0.044).

Conclusion GGT is a marker associated with several metabolic risk factors, which highlights the importance of considering hepatic impairment as a component of this syndrome.