Department of Pediatric Cardiology, Necmettin Erbakan University, Meram School of Medicine Hospital, Konya, Turkey.
Can J Cardiol. 2013 Sep;29(9):1118-25. doi: 10.1016/j.cjca.2012.07.846. Epub 2012 Oct 2.
The recent rise in the prevalence of obesity likely explains nonalcoholic fatty liver disease (NAFLD) epidemic worldwide. We evaluated cardiac functions, cardiovascular risk, and associated parameters with grades of NAFLD in obese children.
Four hundred obese children were enrolled in the study. Obese children with NAFLD were classified in 2 subgroups according to ultrasonographic visualizing. Ninety-three obese children with NAFLD (mean age 11.73 ± 2.72 years in group 2 and 12.69 ± 2.61 years in group 3) were compared with 307 age- and sex-matched non-NAFLD obese children and 150 control subjects. Laboratory parameters were measured during the fasting state. Pulsed and tissue Doppler echocardiography were performed. Intima-media (IMT) and epicardial adipose tissue (EAT) thicknesses were measured.
NAFLD groups had a significantly higher body mass index (29.15 ± 3.42 and 30.46 ± 4.60; P < 0.001), total adipose tissue mass (37.95 ± 4.46% and 46.57 ± 6.45%; P < 0.001), higher insulin, alanine aminotransferase, and aspartate aminotransferase levels. Increased end-systolic thickness of the interventricular septum (P < 0.001), larger left ventricular mass (P < 0.003) and index (P < 0.003) were found in NAFLD groups. Children with NAFLD had higher Tei index values. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Waist and hip circumference, total cholesterol level, total adipose tissue mass, and interventricular septum were statistically different in NAFLD groups.
Children with NAFLD had mildly altered left and right ventricular functions and all obese children had increased IMT and EAT thickness. Also, grade of liver steatosis was positively correlated with total adipose tissue mass and interventricular septum systolic thickness.
肥胖患病率的最近上升可能解释了全球范围内非酒精性脂肪性肝病 (NAFLD) 的流行。我们评估了肥胖儿童的心脏功能、心血管风险以及与 NAFLD 分级相关的参数。
共纳入 400 例肥胖儿童。根据超声可视化将患有 NAFLD 的肥胖儿童分为 2 个亚组。93 例患有 NAFLD 的肥胖儿童（第 2 组的平均年龄为 11.73 ± 2.72 岁，第 3 组为 12.69 ± 2.61 岁）与 307 例年龄和性别匹配的非 NAFLD 肥胖儿童和 150 例对照组进行比较。在空腹状态下测量实验室参数。进行脉冲和组织多普勒超声心动图检查。测量内中膜 (IMT) 和心外膜脂肪组织 (EAT) 厚度。
NAFLD 组的体重指数（29.15 ± 3.42 和 30.46 ± 4.60；P < 0.001）、总脂肪组织质量（37.95 ± 4.46%和 46.57 ± 6.45%；P < 0.001）、更高的胰岛素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平显著更高。NAFLD 组的室间隔收缩末期厚度增加（P < 0.001），左心室质量和指数较大（P < 0.003）。NAFLD 组的 Tei 指数值也较高。此外，肥胖儿童的颈动脉 IMT 和 EAT 厚度明显较高。NAFLD 组的腰围和臀围、总胆固醇水平、总脂肪组织质量和室间隔收缩期在统计学上存在差异。
患有 NAFLD 的儿童左、右心室功能轻度改变，所有肥胖儿童的 IMT 和 EAT 厚度均增加。此外，肝脂肪变性程度与总脂肪组织质量和室间隔收缩期厚度呈正相关。
