Mohamed Rashdan Zaki, Jalaludin Muhammad Yazid, Anuar Zaini Azriyanti
Department of Paediatrics, Hospital Putrajaya, Putrajaya, Malaysia.
Department of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
J Pediatr Endocrinol Metab. 2020 Feb 25;33(2):247-253. doi: 10.1515/jpem-2019-0403.
Background The prevalence of childhood obesity and its related comorbidities in Malaysia are alarming. Malaysia ranked second in childhood obesity among South-east Asian countries with a prevalence of 12.7%. This study was conducted to investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) among obese children and to ascertain the predictors associated with NAFLD. Methods NAFLD was diagnosed via ultrasonographic evidence of fatty liver in obese and overweight children who presented to the Paediatric Obesity Clinic of University Malaya Medical Centre (UMMC), Malaysia. Demographic, anthropometric, clinical and biochemical parameters were analysed and compared between the NAFLD and non-NAFLD groups. Statistical analyses were carried out. Results Twenty-one out of 33 obese and overweight children (63.6%) were found to have NAFLD. We found that 62% of our study population in the NAFLD group had metabolic syndrome based on the definition by the International Diabetes Federation (IDF). Mean body mass index (BMI), waist circumference (WC), triglyceride (TG) and alanine aminotransferase (ALT) were found to be significantly greater in the NAFLD group compared to the non-NAFLD group (35.2 [6.1] vs. 29.3 [4.7] kg/m2 [p-value 0.007]; 104.1 [11.4] vs. 94.1 [12] cm [p-value 0.034]; 1.5 [0.9] vs. 0.9 [0.3] mmol/L [p-value 0.002]; 60.7 [53.8] vs. 27.3 [13] U/L [p-value 0.007]). Multivariate regression analysis revealed TG as the independent predictor for NAFLD, with an odds ratio of 41.7 (95% confidence interval [CI] 0.001, 0.819) (p-value 0.04). Conclusions Prevalence of NAFLD among children who are obese and overweight is alarming with 62% having metabolic syndrome. TG was found to be a strong predictor for NAFLD.
马来西亚儿童肥胖及其相关合并症的患病率令人担忧。在东南亚国家中，马来西亚儿童肥胖患病率位居第二，为12.7%。本研究旨在调查肥胖儿童中非酒精性脂肪性肝病（NAFLD）的患病率，并确定与NAFLD相关的预测因素。方法：通过超声检查确诊为脂肪肝的肥胖和超重儿童被纳入研究，这些儿童均来自马来西亚马来亚大学医学中心（UMMC）的儿科肥胖诊所。对NAFLD组和非NAFLD组的人口统计学、人体测量学、临床和生化参数进行分析和比较，并进行统计分析。结果：33名肥胖和超重儿童中有21名（63.6%）被发现患有NAFLD。根据国际糖尿病联盟（IDF）的定义，我们发现NAFLD组中有62%的研究对象患有代谢综合征。与非NAFLD组相比，NAFLD组的平均体重指数（BMI）、腰围（WC）、甘油三酯（TG）和丙氨酸转氨酶（ALT）显著更高（分别为35.2[6.1] vs. 29.3[4.7] kg/m2[p值0.007]；104.1[11.4] vs. 94.1[12] cm[p值0.034]；1.5[0.9] vs. 0.9[0.3] mmol/L[p值0.002]；60.7[53.8] vs. 27.3[13] U/L[p值0.007]）。多因素回归分析显示TG是NAFLD的独立预测因素，比值比为41.7（95%置信区间[CI] 0.001，0.819）（p值0.04）。结论：肥胖和超重儿童中NAFLD的患病率令人担忧，62%患有代谢综合征。TG被发现是NAFLD的一个强有力的预测因素。
