Gökçe Selim, Atbinici Zehra, Aycan Zehra, Cınar Hasibe Gökçe, Zorlu Pelin
Department of Pediatric Gastroenterology, Dr Sami Ulus Obstetrics and Gynecology, Children's Health and Disease Training and Research Hospital, 06080 Altındağ, Ankara, Turkey.
Pediatr Cardiol. 2013 Feb;34(2):308-15. doi: 10.1007/s00246-012-0447-9. Epub 2012 Aug 9.
To investigate the relationship between nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children. The study included 80 consecutive obese children who were stratified into group 1 [ultrasonographically diagnosed with NAFLD (n = 50)] and group 2 [not diagnosed with NAFLD (n = 30)]. The control group included 30 healthy children. The groups were compared in terms of clinical cardiovascular risk factors and carotid intimal medial thickness (CIMT) (as a marker of atherosclerosis) measured using B-mode ultrasound. Mean body mass index (BMI) and blood pressure (BP), as well as the frequency of dyslipidemia, metabolic syndrome (MetS), and insulin resistance (IR), were similar in groups 1 and 2. Mean BMI and triglyceride (TG) levels, and the frequency of IR and MetS, increased significantly as the grade of steatosis increased. Mean CIMT in group 1 was significantly greater than that in the control group (P < 0.01). There was a positive correlation between CIMT and age, BP, and BMI in groups 1 and 2. In addition, CIMT was correlated with TG, low high-density lipoprotein (HDL) cholesterol, MetS, and IR only in group 1. Linear regression analysis between CIMT and age, BP, BMI, TG level, HDL cholesterol level, IR, MetS, and grade of steatosis yielded a significant difference only for grade of steatosis. Cardiovascular risk factors are more impressive and CIMT was significantly higher in group 1 than in group 2 and the control group, indicating that they are associated with greater risk of atherosclerosis and future adverse cardiovascular events.
探讨肥胖儿童非酒精性脂肪性肝病与心血管危险因素及动脉粥样硬化风险增加之间的关系。该研究纳入了80例连续的肥胖儿童，他们被分为1组[超声诊断为非酒精性脂肪性肝病（n = 50）]和2组[未诊断为非酒精性脂肪性肝病（n = 30）]。对照组包括30名健康儿童。比较了各组的临床心血管危险因素以及使用B型超声测量的颈动脉内膜中层厚度（CIMT）（作为动脉粥样硬化的标志物）。1组和2组的平均体重指数（BMI）、血压（BP）以及血脂异常、代谢综合征（MetS）和胰岛素抵抗（IR）的发生率相似。随着脂肪变性程度的增加，平均BMI、甘油三酯（TG）水平以及IR和MetS的发生率显著升高。1组的平均CIMT显著高于对照组（P < 0.01）。1组和2组中，CIMT与年龄、BP和BMI呈正相关。此外，仅在1组中，CIMT与TG、低高密度脂蛋白（HDL）胆固醇、MetS和IR相关。CIMT与年龄、BP、BMI、TG水平、HDL胆固醇水平、IR、MetS和脂肪变性程度之间的线性回归分析仅在脂肪变性程度方面产生了显著差异。心血管危险因素在1组中比在2组和对照组中更显著，且1组的CIMT显著更高，这表明它们与更高的动脉粥样硬化风险和未来不良心血管事件相关。
