Sert Ahmet, Pirgon Ozgür, Aypar Ebru, Yılmaz Hakan, Dündar Bumin
Süleyman Demirel University, Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Isparta, Turkey. E-mail:
J Clin Res Pediatr Endocrinol. 2013 Sep 10;5(3):182-8. doi: 10.4274/Jcrpe.891.
There is increasing evidence for an association between non-alcoholic fatty liver disease (NAFLD) and an increased risk of cardiovascular morbidity and mortality. The aim of this study was to investigate the association between aspartate aminotransferase-to-platelet ratio index (APRI) and carotid intima-media thickness (IMT) in obese adolescents with NAFLD.
Seventy-six obese adolescents and 36 lean subjects were enrolled in this cross-sectional single-centre study. The obese subjects were divided into two subgroups based on the presence or absence of fatty liver with high transaminase levels (NAFLD group and non-NAFLD group). Fasting blood samples were assayed for transaminase, glucose, and insulin levels. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR).
APRI values were higher in both obese groups (NAFLD and non-NAFLD) in comparison with the lean group. The NAFLD group had significantly higher APRI values than the non-NAFLD obese group and the lean group. Carotid IMT was higher in both obese groups (NAFLD and non-NAFLD) in comparison with the lean group. The NAFLD group had significantly higher measurements of carotid IMT than the non-NAFLD group and the lean group. APRI was positively correlated with most of the metabolic parameters (total cholesterol, low-density lipoprotein cholesterol, glucose, insulin, HOMA-IR) and with carotid IMT in the NAFLD obese group.
This study demonstrated that a significant relationship exists between APRI and carotid IMT in obese adolescents with NAFLD. We suggest that an increased APRI score in obese adolescents with NAFLD can possibly serve to predict a more adverse cardiovascular risk profile.
越来越多的证据表明非酒精性脂肪性肝病(NAFLD)与心血管疾病发病率和死亡率增加之间存在关联。本研究旨在调查NAFLD肥胖青少年中天冬氨酸转氨酶与血小板比值指数(APRI)和颈动脉内膜中层厚度(IMT)之间的关联。
76名肥胖青少年和36名瘦人受试者参与了这项单中心横断面研究。肥胖受试者根据是否存在高转氨酶水平的脂肪肝分为两个亚组(NAFLD组和非NAFLD组)。采集空腹血样检测转氨酶、血糖和胰岛素水平。通过稳态模型评估(HOMA-IR)计算胰岛素抵抗。
与瘦人组相比,两个肥胖组(NAFLD组和非NAFLD组)的APRI值均较高。NAFLD组的APRI值显著高于非NAFLD肥胖组和瘦人组。与瘦人组相比,两个肥胖组(NAFLD组和非NAFLD组)的颈动脉IMT均较高。NAFLD组的颈动脉IMT测量值显著高于非NAFLD组和瘦人组。在NAFLD肥胖组中,APRI与大多数代谢参数(总胆固醇、低密度脂蛋白胆固醇、血糖、胰岛素、HOMA-IR)以及颈动脉IMT呈正相关。
本研究表明,NAFLD肥胖青少年中APRI与颈动脉IMT之间存在显著关系。我们认为,NAFLD肥胖青少年中APRI评分升高可能有助于预测更不利的心血管风险状况。