STUDIES OF LIVER BIOMARKER (ASPARTATE AMINOTRANSFERASE, ALANINEAMINOTRANSFERASE, GAMMA-GLYTAMYL TRANSFERASE, ALKALINE PHOSPHATASES) IN ADOLESCENTS WHO CONSUME ALCOHOL : A SYSTEMATIC REVIEW

Excessive alcohol consumption among adolescents and young adults is an emerging public health issue that can lead to early-onset hepatic abnormalities. Biological biomarkers could help identify at-risk individuals, yet their diagnostic performance and interpretation in young people remain inconsistent. The aim of this review is to systematically evaluate the association between alcohol consumption and hepatic biomarkers (Alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase,and alkaline phosphatase) in adolescents. The protocol for this systematic review was registered on PROSPERO (reference CRD420261395876. We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. A comprehensive search was performed across several databases: PubMed, Scopus, Web of Science Core Collection, PsycINFO, the Cochrane Library, Cairn, and ScienceDirect. The methodological quality of the observational studies was assessed using the Newcastle- Ottawa scale. Among excessive consumers, MCV was significantly higher than in subjects without alcohol abuse (89.94 vs. 87.59 fL; p = 0.001), as was ALT (32.27 vs. 24.03 IU/L; p = 0.038). AST exhibited a trend toward elevation, although the increase did not reach statistical significance (p = 0.064). In subjects with alcohol-associated liver disease, ALT was significantly elevated (41.55 vs. 20.24 IU/L ; p = 0.042). Diagnostic performance varied: sensitivity ranged from 37–85% for GGT and 20–70% for MCV. An AST/ALT ratio > 2 showed high specificity (92–100%). The combination of GGT and MCV achieved a sensitivity of 95%. Enzyme levels were influenced by age, BMI-SDS, and pubertal stage. No single hepatic biomarker allows for the sufficiently accurate screening of excessive alcohol consumption in adolescents and young adults. MCV and ALT appear to be particularly informative parameters, while combining multiple biomarkers could improve screening. Integrating direct biomarkers of consumption specifically phosphatidylethanol with clinical, metabolic, and hepatic assessments could improve the early identification of at-risk youth.