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经活检证实患有非酒精性脂肪性肝病的肥胖儿童的血清胎球蛋白-A水平

Serum Fetuin-A levels in obese children with biopsy proven nonalcoholic fatty liver disease.

作者信息

Pampanini V, Inzaghi E, Germani D, Alterio A, Puglianiello A, Alisi A, Nobili V, Cianfarani S

机构信息

Department of Women's and Children's Health, Pediatric Endocrinology Unit, Karolinska Institutet and University Hospital, 17176, Stockholm, Sweden.

Dipartimento Pediatrico Universitario Ospedaliero "Bambino Gesù" Children's Hospital - Tor Vergata University, 00165, Rome, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2018 Jan;28(1):71-76. doi: 10.1016/j.numecd.2017.09.008. Epub 2017 Oct 3.

Abstract

BACKGROUND AND AIMS

Fetuin-A has been proposed as a marker of liver damage in adults with obesity-related NAFLD. The aim of this study was to test serum fetuin-A concentrations in obese children with NAFLD diagnosed either by ultrasonography or by liver biopsy and to determine its applicability as predictive tool in pediatric NAFLD.

METHODS AND RESULTS

Metabolic parameters and fetuin-A levels were investigated in 81 obese children with NAFLD diagnosed by biopsy, 79 obese children with NAFLD defined by liver ultrasonography and 23 lean subjects. Serum fetuin-A correlated significantly with age, waist circumference, systolic blood pressure, fasting insulin and 2-h postload insulin during OGTT, HOMA-IR, ISI, CRP, and apo B levels. Obese children with NAFLD detected by ultrasonography had significantly higher fetuin-A levels compared to those with normal liver. In obese children who underwent liver biopsy, no significant differences were detected in fetuin-A levels between subject with nonalcoholic steatohepatitis and those with simple steatosis. Fetuin-A was not different between obese and lean children.

CONCLUSION

Fetuin-A is not related with the degree of liver damage in obese children with NAFLD and its routine measurement as marker of liver disease severity is therefore not recommended.

摘要

背景与目的

胎球蛋白-A已被提议作为肥胖相关非酒精性脂肪性肝病(NAFLD)成人患者肝损伤的标志物。本研究旨在检测经超声检查或肝活检诊断为NAFLD的肥胖儿童的血清胎球蛋白-A浓度,并确定其作为儿童NAFLD预测工具的适用性。

方法与结果

对81例经活检诊断为NAFLD的肥胖儿童、79例经肝脏超声检查确诊为NAFLD的肥胖儿童和23例瘦儿童的代谢参数和胎球蛋白-A水平进行了研究。血清胎球蛋白-A与年龄、腰围、收缩压、空腹胰岛素、口服葡萄糖耐量试验(OGTT)期间的2小时负荷后胰岛素、稳态模型评估胰岛素抵抗(HOMA-IR)、胰岛素敏感指数(ISI)、C反应蛋白(CRP)和载脂蛋白B水平显著相关。与肝脏正常的肥胖儿童相比,经超声检查发现患有NAFLD的肥胖儿童的胎球蛋白-A水平显著更高。在接受肝活检的肥胖儿童中,非酒精性脂肪性肝炎患者与单纯性脂肪变性患者的胎球蛋白-A水平未检测到显著差异。肥胖儿童和瘦儿童的胎球蛋白-A水平无差异。

结论

胎球蛋白-A与患有NAFLD的肥胖儿童的肝损伤程度无关,因此不建议将其常规检测作为肝病严重程度的标志物。

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