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应用磁共振评价肥胖青少年非酒精性脂肪肝。

Evaluation of nonalcoholic fatty liver disease using magnetic resonance in obese children and adolescents.

机构信息

Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Ribeirão Preto, SP, Brazil.

Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil.

出版信息

J Pediatr (Rio J). 2019 Jan-Feb;95(1):34-40. doi: 10.1016/j.jped.2017.12.010. Epub 2018 Feb 10.

DOI:10.1016/j.jped.2017.12.010
PMID:29438686
Abstract

OBJECTIVE

To determine the frequency of nonalcoholic fatty liver disease using nuclear magnetic resonance as a noninvasive method.

METHODOLOGY

This was a cross-sectional study conducted on 50 children and adolescents followed up at an outpatient obesity clinic. The subjects were submitted to physical examination, laboratory tests (transaminases, liver function tests, lipid profile, glycemia, and basal insulin) and abdominal nuclear magnetic resonance (calculation of hepatic, visceral, and subcutaneous fat).

RESULTS

Nonalcoholic fatty liver disease was diagnosed in 14 (28%) participants, as a severe condition in eight (percent fat >18%), and as non-severe in four (percent fat from 9% to 18%). Fatty liver was associated with male gender, triglycerides, AST, ALT, AST/ALT ratio, and acanthosis nigricans. Homeostasis model assessment of insulin resistance and metabolic syndrome did not show an association with fatty liver.

CONCLUSION

The frequency of nonalcoholic fatty liver disease in the present population of children and adolescents was lower than that reported in the international literature. It is suggested that nuclear magnetic resonance is an imaging exam that can be applied to children and adolescents, thus representing an effective noninvasive tool for the diagnosis of nonalcoholic fatty liver disease in this age range. However, further national multicenter studies with longitudinal design are needed for a better analysis of the correlation between nonalcoholic fatty liver disease and its risk factors, as well as its consequences.

摘要

目的

采用磁共振作为一种非侵入性方法来确定非酒精性脂肪性肝病的发病率。

方法

这是一项横断面研究,共纳入 50 名在肥胖门诊接受随访的儿童和青少年。对受试者进行体格检查、实验室检查(转氨酶、肝功能检查、血脂谱、血糖和基础胰岛素)和腹部磁共振检查(计算肝、内脏和皮下脂肪)。

结果

14 名(28%)参与者被诊断为非酒精性脂肪性肝病,8 名(脂肪百分比>18%)为重度,4 名(脂肪百分比为 9%至 18%)为非重度。脂肪肝与男性、甘油三酯、AST、ALT、AST/ALT 比值和黑棘皮病有关。胰岛素抵抗和代谢综合征的稳态模型评估与脂肪肝无相关性。

结论

本研究中儿童和青少年的非酒精性脂肪性肝病发病率低于国际文献报道。建议磁共振成像检查可应用于儿童和青少年,是诊断该年龄段非酒精性脂肪性肝病的有效非侵入性工具。但是,需要进一步开展全国性、多中心、设计合理的研究,以更好地分析非酒精性脂肪性肝病及其危险因素之间的相关性,以及其后果。

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