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肥胖儿童非酒精性脂肪性肝病与心血管疾病的关系

[Relationship between nonalcoholic fatty liver disease and cardiovascular disease in children with obesity].

作者信息

Liu Li-Rui, Fu Jun-Fen, Liang Li, Huang Ke

机构信息

Department of Endocrinology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2010 Jul;12(7):547-50.

PMID:20637154
Abstract

OBJECTIVE

To study the relationship between nonalcoholic fatty liver disease (NAFLD) and the development of cardiovascular disease (CVD) in children with obesity.

METHODS

Two hundred and thirty-one obese children and 24 non-obese children as control were enrolled. Body mass index (BMI), serum triglyceride, blood pressure, liver function, and carotid artery intima-media thickness (IMT) were examined. The obese children were classified into two subgroups according to the diagnosis criteria: group 1 without liver disorder (OCWLD group, n=75) and group 2 with NAFLD (NAFLD group, n=156). The incidences of hyperlipidemia and hypertension, carotid artery intima-media thickness (IMT) and biochemical indicators were compared in the three groups.

RESULTS

The NAFLD group showed significantly greater carotid IMT (0.066+/-0.021 cm) than the OCWLD (0.060+/-0.011 cm) and control groups (0.037+/-0.007 cm) (P<0.05). The OCWLD group had also thicker IMT than the control group (P<0.05). The incidences of hyperlipidemia and hypertension were 39.7% and 40.4%, respectively in the NAFLD group, which were significantly higher than those in the OCWLD (22.7% and 29.3% respectively)and control groups (4.2% and 12.6% respectively) (P<0.05). The liner stepwise regression analysis showed that the IMT was positively correlated with BMI, NAFLD and ALT (adjusted R2=0.316, P<0.01).

CONCLUSIONS

NAFLD may be not only an early marker but also an early state of CVD in obese children. Early diagnosis and treatment of NAFLD is crucial for the prevention of the occurrence and development of CVD.

摘要

目的

研究肥胖儿童非酒精性脂肪性肝病(NAFLD)与心血管疾病(CVD)发生之间的关系。

方法

纳入231名肥胖儿童和24名非肥胖儿童作为对照。检测体重指数(BMI)、血清甘油三酯、血压、肝功能和颈动脉内膜中层厚度(IMT)。根据诊断标准将肥胖儿童分为两个亚组:1组无肝脏疾病(OCWLD组,n = 75)和2组患有NAFLD(NAFLD组,n = 156)。比较三组高脂血症和高血压的发生率、颈动脉内膜中层厚度(IMT)和生化指标。

结果

NAFLD组的颈动脉IMT(0.066±0.021cm)显著高于OCWLD组(0.060±0.011cm)和对照组(0.037±0.007cm)(P<0.05)。OCWLD组的IMT也比对照组厚(P<0.05)。NAFLD组高脂血症和高血压的发生率分别为39.7%和40.4%,显著高于OCWLD组(分别为22.7%和29.3%)和对照组(分别为4.2%和12.6%)(P<0.05)。线性逐步回归分析显示,IMT与BMI、NAFLD和ALT呈正相关(调整R2 = 0.316,P<0.01)。

结论

NAFLD可能不仅是肥胖儿童CVD的早期标志物,也是其早期状态。NAFLD的早期诊断和治疗对于预防CVD的发生和发展至关重要。

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