Newton Kimberly P, Feldman Haruna S, Chambers Christina D, Wilson Laura, Behling Cynthia, Clark Jeanne M, Molleston Jean P, Chalasani Naga, Sanyal Arun J, Fishbein Mark H, Lavine Joel E, Schwimmer Jeffrey B
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA; Division of Gastroenterology, Department of Pediatrics, Rady Children's Hospital, San Diego, CA.
Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego, La Jolla, CA.
J Pediatr. 2017 Aug;187:141-146.e1. doi: 10.1016/j.jpeds.2017.03.007. Epub 2017 Mar 30.
To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD.
A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category.
Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62).
Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease.
研究非酒精性脂肪性肝病（NAFLD）患儿的出生体重分布情况，并与美国普通人群进行比较，同时探讨出生体重与NAFLD严重程度之间的关系。
一项多中心横断面研究，研究对象为非酒精性脂肪性肝炎临床研究网络数据库中经活检证实患有NAFLD的儿童。出生体重分为低出生体重（LBW）、正常出生体重（NBW）或高出生体重（HBW），并与美国普通人群的出生体重分布进行比较。根据出生体重类别评估肝脏组织学的严重程度。
与美国普通人群相比，NAFLD患儿（n = 538）中LBW和HBW的比例过高（LBW：9.3%；NBW：75.8%；HBW：14.9%，而美国普通人群中LBW：6.1%；NBW：83.5%；HBW：10.5%；P <.0001）。与NBW患儿相比，HBW患儿发生更严重脂肪变性（OR，1.82；95%CI，1.15 - 2.88）和非酒精性脂肪性肝炎（OR，2.03；95%CI，1.21 - 3.40）的几率显著更高。此外，NAFLD合并LBW的患儿发生晚期纤维化的几率显著更高（OR，2.23；95%CI，1.08 - 4.62）。
出生体重涉及母体和子宫内因素，可能会产生长期影响。LBW和HBW儿童患NAFLD的风险可能会增加。在患有NAFLD的儿童中，LBW或HBW儿童患更严重疾病的风险似乎会增加。
