Zhou Xin, Hou Dong-qing, Duan Jia-li, Sun Ying, Cheng Hong, Zhao Xiao-yuan, Liu Jun-ting, Yang Ping, Shan Xin-ying, Mi Jie
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2013 May;34(5):446-50.
To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic abnormalities in obese children and adolescents in Beijing.
This study involved 387 obese children and adolescents, aged 12 to 17 years in Beijing. Data on anthropometric measurements was collected, including weight, height and age. All subjects underwent a clinic examination containing fasting blood and liver ultrasonography. Nonalcoholic fatty liver disease was diagnosed using diagnostic criteria for nonalcoholic fatty liver disease which was recommended by the Fatty liver and Alcoholic Liver Disease Study Group of Liver Disease Association in China.
174 out of the 387 children were diagnosed as having NAFLD. The overall prevalence of NAFLD was 45.0% in this study population. The prevalence rates of NAFLD did not show significant difference between girls and boys. The prevalence rates of diabetes mellitus and IFG were 0.8% and 49.1% respectively. The prevalence rates of HTG, HTC, HLDL-C, LHDL-C, IFG, elevated ALT (or AST) and acanthosis nigricans were 6.3%, 4.0%, 37.9%, 22.8%, 46.0%, 17.8% and 28.5% in students combined with obesity and NAFLD, respectively. In the NAFLD subgroup, higher prevalence of high TG, acanthosis nigricans, abnormal ALT or AST were seen. With the increasing of obesity, the level of LDL-C, TG, liver function disturbance and prevalence of NAFLD and acanthosis nigricans were aggravated. Under binary logistic regression analysis, results showed that high BMI, acanthosis nigricans and TG were significantly correlated with NAFLD in obese children and adolescent population.
NAFLD was common in obese children, and the prevalence of NAFLD in obese children was 45.0%. Higher BMI, acanthosis nigricans and abnormal TG were independent risk factors for NAFLD in obese children. Obese children who had been exposed to high risk factors should take the ultrasonography.
确定北京肥胖儿童及青少年中非酒精性脂肪性肝病（NAFLD）的患病率及代谢异常情况。
本研究纳入了387名年龄在12至17岁的北京肥胖儿童及青少年。收集了人体测量数据，包括体重、身高和年龄。所有受试者均接受了包含空腹血液检查和肝脏超声检查的临床检查。采用中国肝病协会脂肪肝和酒精性肝病研究组推荐的非酒精性脂肪性肝病诊断标准来诊断非酒精性脂肪性肝病。
387名儿童中有174名被诊断为患有NAFLD。本研究人群中NAFLD的总体患病率为45.0%。NAFLD的患病率在女孩和男孩之间未显示出显著差异。糖尿病和空腹血糖受损（IFG）的患病率分别为0.8%和49.1%。在合并肥胖和NAFLD的学生中，高甘油三酯血症（HTG）、高胆固醇血症（HTC）、高密度脂蛋白胆固醇（HLDL-C）、低密度脂蛋白胆固醇（LHDL-C）、IFG、谷丙转氨酶（ALT）（或谷草转氨酶（AST））升高及黑棘皮症的患病率分别为6.3%、4.0%、37.9%、22.8%、46.0%、17.8%和28.5%。在NAFLD亚组中，高甘油三酯、黑棘皮症、ALT或AST异常的患病率更高。随着肥胖程度的增加，低密度脂蛋白胆固醇、甘油三酯水平、肝功能障碍以及NAFLD和黑棘皮症的患病率均加重。二元逻辑回归分析结果显示，高体重指数（BMI）、黑棘皮症和甘油三酯与肥胖儿童及青少年人群中的NAFLD显著相关。
NAFLD在肥胖儿童中很常见，肥胖儿童中NAFLD的患病率为45.0%。较高的BMI、黑棘皮症和异常的甘油三酯是肥胖儿童患NAFLD的独立危险因素。暴露于高危因素的肥胖儿童应接受超声检查。
