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铁蛋白作为肥胖儿童非酒精性脂肪性肝病的关键风险因素。

Ferritin as a key risk factor for nonalcoholic fatty liver disease in children with obesity.

机构信息

Department of Clinical Laboratory, School of Medicine, The Children's Hospital, Zhejiang University, Zhejiang, China.

National Clinical Research Center for Child Health, Hangzhou, China.

出版信息

J Clin Lab Anal. 2021 Feb;35(2):e23602. doi: 10.1002/jcla.23602. Epub 2020 Nov 28.

Abstract

BACKGROUND

The association between serum ferritin and nonalcoholic fatty liver disease (NAFLD) in children with obesity is not clear. This study was designed to investigate whether serum ferritin can be an independent predictor for NAFLD.

METHODS

According to the hepatic ultrasound results, a total of 347 children with obesity were enrolled in this study. Among them, 95 patients with NAFLD and 95 without NAFLD were matched for gender, age, blood pressure and body mass index, the odds ratios (OR) and 95% confidence intervals (CI) for the association of ferritin and the risk of NAFLD were analyzed.

RESULTS

After propensity score matching, ferritin values of the patients with NAFLD were significantly higher than those without NAFLD group. Alanine aminotransferase and ferritin were strongly associated with NAFLD in multivariate stepwise logistic regression analysis. The medium and high levels of ferritin increased risk of NAFLD, and the adjusted ORs were 3.298 (95% CI:1.326-8.204), 7.322 (95% CI:2.725-19.574) across the ferritin concentration tertiles after adjustment for confounders. Ferritin was shown to be the best predictor for NAFLD with sensitivity and specificity of 60.0% and 77.9%, respectively, area under the curve was 0.733.

CONCLUSION

The results show that serum ferritin can usefully be considered as a predictor of NAFLD in children with obesity.

摘要

背景

血清铁蛋白与儿童肥胖中非酒精性脂肪肝(NAFLD)之间的关系尚不清楚。本研究旨在探讨血清铁蛋白是否可作为 NAFLD 的独立预测因子。

方法

根据肝脏超声结果,共纳入 347 例肥胖儿童。其中,95 例 NAFLD 患儿与 95 例非 NAFLD 患儿按性别、年龄、血压和体重指数匹配,分析铁蛋白与 NAFLD 风险的关联的比值比(OR)和 95%置信区间(CI)。

结果

经倾向评分匹配后,NAFLD 患儿的铁蛋白值明显高于非 NAFLD 组。丙氨酸氨基转移酶和铁蛋白在多元逐步逻辑回归分析中与 NAFLD 密切相关。中、高水平铁蛋白增加了 NAFLD 的发病风险,调整后的 OR 值分别为 3.298(95%CI:1.326-8.204)和 7.322(95%CI:2.725-19.574),经混杂因素调整后,铁蛋白浓度三分位组均如此。铁蛋白对 NAFLD 的预测效果最佳,其敏感性和特异性分别为 60.0%和 77.9%,曲线下面积为 0.733。

结论

结果表明,血清铁蛋白可作为肥胖儿童 NAFLD 的有效预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6832/7891541/265e2161db6d/JCLA-35-e23602-g001.jpg

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