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意大利唐氏综合征儿童的非酒精性脂肪性肝病:患病率及其与肥胖相关特征的相关性

Nonalcoholic Fatty Liver Disease in Italian Children with Down Syndrome: Prevalence and Correlation with Obesity-Related Features.

作者信息

Valentini Diletta, Alisi Anna, di Camillo Chiara, Sartorelli Maria Rita, Crudele Annalisa, Bartuli Andrea, Nobili Valerio, Villani Alberto

机构信息

Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, Institute for Research and Health Care (IRCCS), Rome, Italy.

Liver Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

J Pediatr. 2017 Oct;189:92-97.e1. doi: 10.1016/j.jpeds.2017.05.077. Epub 2017 Jun 26.

Abstract

OBJECTIVE

To assess the prevalence of overweight/obesity in a cohort of Italian children with Down syndrome (DS) and to investigate the correlation of both obesity and DS with nonalcoholic fatty liver disease (NAFLD).

STUDY DESIGN

We enrolled 280 children with DS (age range 5-18 years), who were referred to the DS outpatient clinic of the Bambino Gesù Children's Hospital in Rome. For all children, we collected the clinical history and measured anthropometric variables. Eighty-four of 280 children with DS were selected to undergo liver ultrasound scanning to evaluate the presence of NAFLD.

RESULTS

Italian children with DS exhibited a prevalence of 19.64% for overweight and 12.14% for obesity. The prevalence of NAFLD in nonobese (45%) and overweight/obese (82%) children with DS is greater than in the European pediatric nonobese (5.7%) or obese population (33%). Moreover, the severity of liver brightness on ultrasound scan correlated positively with body mass index, triglycerides, low-density lipoprotein-cholesterol, and leptin levels and negatively with adiponectin.

CONCLUSIONS

We demonstrated that, independently from the obese phenotype, children with DS display a greater risk to develop NAFLD than the general pediatric population.

摘要

目的

评估一组意大利唐氏综合征(DS)患儿超重/肥胖的患病率,并研究肥胖和DS与非酒精性脂肪性肝病(NAFLD)的相关性。

研究设计

我们纳入了280名DS患儿(年龄范围5 - 18岁),这些患儿被转诊至罗马的 Bambino Gesù儿童医院的DS门诊。对于所有患儿,我们收集了临床病史并测量了人体测量学变量。在280名DS患儿中,选取84名进行肝脏超声扫描以评估NAFLD的存在情况。

结果

意大利DS患儿超重患病率为19.64%,肥胖患病率为12.14%。DS非肥胖患儿(45%)和超重/肥胖患儿(82%)的NAFLD患病率高于欧洲儿科非肥胖人群(5.7%)或肥胖人群(33%)。此外,超声扫描中肝脏亮度的严重程度与体重指数、甘油三酯、低密度脂蛋白胆固醇和瘦素水平呈正相关,与脂联素呈负相关。

结论

我们证明,独立于肥胖表型,DS患儿发生NAFLD的风险高于一般儿科人群。

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