Imhof Armin, Kratzer Wolfgang, Boehm Bernhard, Meitinger Katrin, Trischler Gerlinde, Steinbach Gerald, Piechotowski Isolde, Koenig Wolfgang
Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Germany.
Eur J Epidemiol. 2007;22(12):889-97. doi: 10.1007/s10654-007-9181-7. Epub 2007 Sep 25.
Overweight and obesity among children and adolescents are increasing. Fatty liver disease (FLD) is an emerging problem in this age group. We investigated prevalence of overweight and non-invasive FLD and associated clinical characteristics in a representative population-based sample of 378 children and adolescents aged 12-20 years who were randomly selected from the general population in Leutkirch, Southern Germany. Overweight was defined as having a body mass index above the 90th percentile for the respective age and sex. About 15% of female (29 out of 194) and 12% of male participants (22/182) were overweight. Among females, only one non-overweight individual showed signs of FLD but in more than one third of the overweight males (8/22) signs of FLD were present. Overweight subjects in general had an unfavourable lipid profile and abnormal concentrations of obesity-related hormones such as significantly lower concentrations of adiponectin and increased levels of inflammatory markers including C-reactive protein and fibrinogen. Overweight males with signs of FLD showed even more severe altered metabolic responses compared to those who were overweight without signs of liver injury. FLD was not explained by alcohol consumption or other chronic liver disease. In this sample of children and adolescents representative of the general population a high prevalence of non-alcoholic fatty liver disease (NAFLD) is found in overweight males. These individuals showed the most severe metabolic alterations compared to non-overweight and overweight individuals without NAFLD indicating even higher risk for future overweight and obesity-related diseases such as type 2 diabetes and cardiovascular disease.
儿童和青少年中的超重和肥胖现象正在增加。脂肪性肝病（FLD）在这个年龄组中是一个新出现的问题。我们在德国南部洛伊特基希从普通人群中随机选取的378名12至20岁儿童和青少年的具有代表性的基于人群的样本中，调查了超重和非侵入性FLD的患病率及相关临床特征。超重被定义为体重指数高于相应年龄和性别的第90百分位数。约15%的女性参与者（194人中的29人）和12%的男性参与者（182人中的22人）超重。在女性中，只有一名非超重个体有FLD迹象，但在超过三分之一的超重男性（22人中的8人）中有FLD迹象。一般来说，超重受试者的血脂谱不良，肥胖相关激素浓度异常，如脂联素浓度显著降低，炎症标志物水平升高，包括C反应蛋白和纤维蛋白原。与没有肝损伤迹象的超重男性相比，有FLD迹象的超重男性的代谢反应改变更为严重。FLD不能用饮酒或其他慢性肝病来解释。在这个代表普通人群的儿童和青少年样本中，超重男性中非酒精性脂肪性肝病（NAFLD）的患病率很高。与没有NAFLD的非超重和超重个体相比，这些个体表现出最严重的代谢改变，表明他们未来患2型糖尿病和心血管疾病等超重和肥胖相关疾病的风险更高。
