MRI 诊断的非酒精性脂肪肝疾病与青少年的胰岛素抵抗相关。

MRI-diagnosed nonalcoholic fatty liver disease is correlated to insulin resistance in adolescents.

机构信息

Department of Radiology, Hospital Sao Lucas Hospital, Pontifícia Universidade Católica do Rio Grande do Sul, 90470320 Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Acad Radiol. 2013 Nov;20(11):1436-42. doi: 10.1016/j.acra.2013.08.016.

DOI:10.1016/j.acra.2013.08.016

PMID:24119357

Abstract

RATIONALE AND OBJECTIVES

To evaluate the presence of nonalcoholic fatty liver disease (NAFLD) in eutrophic and obese adolescents with magnetic resonance imaging (MRI) and its relationship to insulin resistance and other potential biomarkers.

MATERIALS AND METHODS

A total of 50 adolescents (aged 11-17 years), including 24 obese and 26 eutrophic adolescents, were evaluated using MRI exams for NAFLD diagnosis. Blood analysis was performed to measure glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, fibrinogen, aminotransferases, alkaline phosphatase, gamma-gt, and C-reactive protein. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index was also calculated. Laboratory test results and anthropometric assessment were statistically analyzed to determine potential correlation with NAFLD prevalence.

RESULTS

The prevalence of NAFLD among the obese was significantly higher (83.3%; CI 95: 64.5-94.5%) than that of the eutrophic group (19.2%; CI 95: 7.4-37.6%). In multivariate analysis, only HOMA-IR was an independent risk factor for diagnosis NAFLD using MRI. Compared to eutrophic adolescents, the obese adolescents had significantly higher levels for all parameters measured except for total and high-density lipoprotein cholesterol, which were significantly lower.

CONCLUSION

The prevalence of NAFLD was 19.2% among eutrophic patients and 83.3% among obese patients. Only HOMA-IR was determined to be an independent risk factor for NAFLD.

摘要

目的

使用磁共振成像（MRI）评估肥胖和超重青少年中非酒精性脂肪性肝病（NAFLD）的存在情况，并研究其与胰岛素抵抗和其他潜在生物标志物的关系。

材料与方法

共纳入 50 名青少年（年龄 11-17 岁），包括 24 名肥胖青少年和 26 名超重青少年，采用 MRI 检查对 NAFLD 进行诊断。采集血液样本以检测血糖、胰岛素、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、纤维蛋白原、氨基转移酶、碱性磷酸酶、γ-谷氨酰转移酶和 C 反应蛋白。同时还计算了胰岛素抵抗稳态模型评估（HOMA-IR）指数。对实验室检查结果和人体测量评估结果进行统计学分析，以确定与 NAFLD 患病率相关的因素。

结果

肥胖青少年的 NAFLD 患病率显著高于超重青少年（83.3%；95%CI：64.5-94.5% vs. 19.2%；95%CI：7.4-37.6%）。多变量分析显示，只有 HOMA-IR 是 MRI 诊断 NAFLD 的独立危险因素。与超重青少年相比，肥胖青少年除总胆固醇和高密度脂蛋白胆固醇水平显著降低外，所有测量参数水平均显著升高。