Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain.
PROmoting FITness and Health through physical activity research group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
Pediatr Diabetes. 2020 Jun;21(4):565-574. doi: 10.1111/pedi.13011. Epub 2020 Apr 12.
Non-alcoholic fatty liver disease is the most common liver disease in childhood and is related to insulin resistance and cardiometabolic risk factors. Evidence supporting the association of fitness and physical activity with hepatic fat, liver enzymes, or triglyceride-to-high-density lipoprotein ratio is scarce in children.
To analyze the associations of physical fitness and physical activity (PA) with percentage hepatic fat, liver enzymes, insulin resistance, and cardiometabolic risk in children with overweight/obesity.
A total of 115 children (10.6 ± 1.1 years; 54% girls) with overweight/obesity of the EFIGRO study (ClinicalTrials.gov: NCT02258126) were included in the analyses.
Cardiorespiratory fitness (CRF), musculoskeletal fitness and speed-agility were measured by the Alpha-fitness tests, and PA by wGT3X-BT accelerometers. Percentage hepatic fat was assessed by magnetic resonance imaging. Alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), insulin, glucose, triglycerides (TG), and high-density lipoprotein (HDL) levels were obtained from fasting blood samples. The homeostasis model assessment insulin resistance (HOMA-IR) and AST/ALT and TG/HDL ratios were calculated.
Higher CRF was associated with lower percentage hepatic fat (β = -0.266, P = .01) and GGT (β = -0.315, P < .01), and higher AST/ALT ratio (β = 0.306, P < .01). CRF-fit children have lower GGT levels (15 ± 1 vs 17 ± 1 U/L, CRF-fit vs CRF-unfit children, P = .02), HOMA-IR (2.2 ± 0.1 vs 2.9 ± 0.1, P < .01) and TG/HDL ratio (1.4 ± 0.1 vs 1.9 ± 0.1, P = .01) and higher AST/ALT ratio (1.3 ± 0.0 vs 1.2 ± 0.0, P = .03), than CRF-unfit children.
These findings emphasize the importance of considering the improvement of CRF as a target of programs for preventing hepatic steatosis, type 2 diabetes and cardiovascular diseases in children with overweight.
非酒精性脂肪肝是儿童中最常见的肝脏疾病，与胰岛素抵抗和心血管代谢危险因素有关。在儿童中，支持身体健康和身体活动与肝脂肪、肝酶或甘油三酯与高密度脂蛋白比值之间关联的证据很少。
分析超重/肥胖儿童的身体健康和身体活动（PA）与肝脂肪百分比、肝酶、胰岛素抵抗和心血管代谢风险的关系。
EFIGRO 研究（ClinicalTrials.gov：NCT02258126）共纳入 115 名超重/肥胖儿童（10.6±1.1 岁；54%为女孩），进行分析。
心肺功能（CRF）、肌肉骨骼健康和速度敏捷性通过 Alpha 健身测试测量，身体活动通过 wGT3X-BT 加速度计测量。通过磁共振成像评估肝脂肪百分比。从空腹血样中获得丙氨酸氨基转移酶（ALT）、γ-谷氨酰转移酶（GGT）、天冬氨酸氨基转移酶（AST）、胰岛素、葡萄糖、甘油三酯（TG）和高密度脂蛋白（HDL）水平。计算稳态模型评估胰岛素抵抗（HOMA-IR）和 AST/ALT 及 TG/HDL 比值。
较高的 CRF 与较低的肝脂肪百分比（β=-0.266，P=.01）和 GGT（β=-0.315，P<.01）以及较高的 AST/ALT 比值（β=0.306，P<.01）相关。CRF 正常的儿童的 GGT 水平较低（15±1 vs 17±1 U/L，CRF 正常的儿童比 CRF 异常的儿童，P=.02），HOMA-IR（2.2±0.1 vs 2.9±0.1，P<.01）和 TG/HDL 比值（1.4±0.1 vs 1.9±0.1，P=.01）以及较高的 AST/ALT 比值（1.3±0.0 vs 1.2±0.0，P=.03），与 CRF 异常的儿童相比。
这些发现强调了将 CRF 改善作为超重儿童预防脂肪肝、2 型糖尿病和心血管疾病计划目标的重要性。
