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This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the National Center for Health Statistics Research Ethics Review Board (CDC, 2016). Written informed consent was obtained from all subjectspatients., Robinson Ramírez‐Vélez researched data and contributed to the discussion. Mikel Izquierdo and María Correa‐Rodríguez reviewed/edited the manuscript. Robinson Ramírez‐Vélez and María Correa‐Rodríguez wrote the manuscript. Robinson Ramírez‐Vélez and Antonio García‐Hermoso are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., The lead author affirms that this manuscript is an honest, accurate and transparent account of the study being reported. The reporting of this work is compliant with STROBE guidelines. The lead author affirms that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained., Background: There is limited evidence on the role of an anti-/pro-inflammatory diet in the prevention of non-alcoholic fatty liver disease (NAFLD). We aimed (i) to assess the anti-inflammatory diet profile and its association with transient elastography parameters, including liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), and (ii) to analyse the relationship between the anti-inflammatory diet and surrogate markers of liver disease in a multiethnic US population. Methods: A cross-sectional study was conducted on a nationally representative population of 4189 US adults aged 20–80 years. A FibroScan® 502 V2 device (Echosens) was used to estimate the CAP and LSM. Liver markers, including the aspartate transaminase (AST) to alanine transaminase (ALT) ratio, fatty liver index (FLI) and fibrosis-4 score, were also calculated. The Dietary Inflammatory Index (DII) was calculated using a 24-h diet recall. Results: Lower DII scores (anti-inflammatory diet) were associated with a lower AST:ALT ratio (p < 0.001) and FLI (p < 0.036) after adjusting for covariates. Linear regression analysis revealed that gamma-glutamyl transferase levels (β = 1.702, 95% confidence interval [CI] = 0.325–3.080, p = 0.015), ALT levels (β = −0.616, 95% CI = −1.097 to −0.135, p = 0.012), AST:ALT ratio (β = 0.025, 95% CI = 0.014–0.036, p < 0.001) and FLI (β = 1.168, 95% CI = 0.224–2.112, p = 0.015) were significantly associated with the DII in the multivariable-adjusted model. Participants in the highest anti-inflammatory tertile had the lowest odds ratio (OR) for NAFLD assessed by FLI in both unadjusted (OR = 0.652, 95% CI = 0.539–0.788, p ≤ 0.001) and adjusted models (OR = 0.722, 95% CI = 0.537–0.972, p = 0.032). For the transient elastography parameters (LSM and CAP), no significant associations were identified. Conclusions: There was no relationship between the transient elastography parameters and the anti-inflammatory diet profile, although our study showed an association between higher pro-inflammatory properties of diet and poorer hepatic health assessed by surrogate markers of liver disease. Therefore, strategies to promote an anti-inflammatory diet should be considered to prevent NAFLD in adults., Funding for open access charge, Universidad de Granada/CBUA

Background: There is a high prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among pediatric patients. The identification of clinical predictors of these conditions would allow a timely treatment. Aim: To evaluate the relationship between serum alanine aminotransferase levels and parameters of metabolic syndrome in asymptomatic school students without hepatic illness. Subjects and Methods: A randomized sample of 175 children aged between 9 and 14 years (54% females) was selected, from a database of 3010 students living in Santiago, Chile. Weight, height, abdominal circumference, systolic and diastolic blood pressure were measured. A fasting blood sample was obtained to measure glucose, total cholesterol, HDL, LDL-cholesterol, triglycerides, alanine aminotransferase (ALT) and insulin levels. Results: Forty percent of participants were obese, 17% had metabolic syndrome and 13.1% had abnormal ALT levels. Compared with children with normal ALT levels, the latter had significantly higher waist obesity, body mass index, systolic and diastolic blood pressure and triglycerides. However on multiva-riate analysis, only waist obesity was independently associated with abnormal ALT levels (adjusted odds ratio 3.93, 95% confidence intervals 1.44-10.78, p = 0.008). Conclusions: Only waist obesity was independently associated with abnormal ALT levels in this sample of children.