Medical Research Council Integrative Epidemiology Unit (D.A.L., C.M.-W., E.A., A.F., L.D.H.) and School of Social and Community Medicine (D.A.L., C.M.-W., E.A., A.F., L.D.H.), University of Bristol, Bristol BS8 2BN, United Kingdom; University Hospitals Bristol National Health Service Foundation Trust (M.C.), Bristol BS1 3NU, United Kingdom; Institute of Cellular Medicine (C.D.), Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE1 7RU, United Kingdom; and Institute of Cardiovascular and Medical Sciences (N.S.), BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, University of Glasgow, Glasgow G12 8TA, United Kingdom.
J Clin Endocrinol Metab. 2014 Mar;99(3):E410-7. doi: 10.1210/jc.2013-3612. Epub 2014 Jan 28.
The impact of adolescent nonalcoholic fatty liver disease (NAFLD) on health, independent of fat mass, is unclear.
The objective of the study was to determine the independent (of total body fat) association of ultrasound scan (USS)-determined NAFLD with liver fibrosis, insulin resistance, and dyslipidemia among healthy adolescents.
This was a cross-sectional analysis in participants from a UK birth cohort.
One thousand eight hundred seventy-four (1059 female) individuals of a mean age of 17.9 years participated in the study.
USS assessed liver stiffness (shear velocity, an indicator of fibrosis) and volume, fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, γ-glutamyltransferase, and haptoglobin.
The prevalence of NAFLD was 2.5% [95% confidence interval (CI) 1.8-3.3] and was the same in females and males. Dual-energy X-ray absorptiometry determined total body fat mass was strongly associated with USS NAFLD: odds ratio 3.15 (95% CI 2.44-4.07) per 1 SD (∼10 kg) fat mass. Those with NAFLD had larger liver volumes and greater shear velocity. They also had higher fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, γ-glutamyltransferase, and haptoglobin and lower high-density lipoprotein cholesterol. Most associations were independent of total body fat. For example, after adjustment for fat mass and other confounders, hepatic shear velocity [mean difference 22.8% (95% CI 15.6-30.5)], triglyceride levels [23.6% (95% CI 6.0-44.2)], and insulin [39.4% (95% CI 10.7-75.5)] were greater in those with NAFLD compared with those without NAFLD.
In healthy European adolescents, 2.5% have USS-defined NAFLD. Even after accounting for total body fat, those with NAFLD have more adverse levels of liver fibrosis and cardiometabolic risk factors.
青少年非酒精性脂肪性肝病（NAFLD）对健康的影响，独立于脂肪量，目前尚不清楚。
本研究旨在确定超声扫描（USS）确定的 NAFLD 与健康青少年的肝纤维化、胰岛素抵抗和血脂异常的独立（与全身脂肪无关）关联。
这是一项在英国出生队列参与者中进行的横断面分析。
1874 名（1059 名女性）平均年龄为 17.9 岁的个体参加了这项研究。
USS 评估了肝脏硬度（剪切速度，纤维化的指标）和体积、空腹血糖、胰岛素、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转移酶和触珠蛋白。
NAFLD 的患病率为 2.5%（95%置信区间 1.8-3.3），在女性和男性中相同。双能 X 射线吸收法测定的全身脂肪量与 USS 诊断的 NAFLD 密切相关：每增加 1 个标准差（约 10 公斤）脂肪量，比值比为 3.15（95%置信区间 2.44-4.07）。患有 NAFLD 的个体肝脏体积更大，剪切速度更高。他们的空腹血糖、胰岛素、甘油三酯、低密度脂蛋白胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转移酶和触珠蛋白水平更高，而高密度脂蛋白胆固醇水平较低。大多数关联独立于全身脂肪。例如，在调整脂肪量和其他混杂因素后，NAFLD 患者的肝剪切速度[平均差异 22.8%（95%置信区间 15.6-30.5%）]、甘油三酯水平[23.6%（95%置信区间 6.0-44.2%）]和胰岛素[39.4%（95%置信区间 10.7-75.5%）]均高于无 NAFLD 患者。
在欧洲健康青少年中，有 2.5%的人通过 USS 定义为 NAFLD。即使考虑到全身脂肪量，患有 NAFLD 的个体也有更多不良的肝纤维化和心血管代谢危险因素水平。
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