Pediatric Department, Faculty of Medicine, Tanta University, El motasem street No 6, Tanta, Egypt.
Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Eur J Pediatr. 2021 Jun;180(6):1693-1699. doi: 10.1007/s00431-021-03941-3. Epub 2021 Jan 21.
Association between pulmonary function tests (PFTs) and non-alcoholic fatty liver disease (NAFLD) has been reported in adult studies; however, there is lack of pediatric studies. Our study aimed to evaluate PFTs in children with NAFLD. A total of 137 children with NAFLD and 100 healthy children of matched age and sex were included in the study. Different PFTs including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and total lung capacity (TLC) were performed for all included children. Lipid profile, insulin resistance, fasting and postprandial glucose level, and high sensitive C reactive protein (hs-CRP) were measured. FEV1 %, FVC %, FEV1/FVC ratio, RV, and TLC were significantly lower in the patient group compared with the control group (P < 0.05), while RV and hs-CRP were significantly higher in children with NAFLD. Restrictive lung dysfunction was the commonest pulmonary dysfunction detected in children with NAFLD (21.9%). PFT indices were significantly correlated with grade and duration of NAFLD, insulin resistance, waist circumference, and hs-CRP. Regression analysis revealed that insulin resistance and hs-CRP were independently associated with decreased PFT indices.Conclusion: PFT indices were impaired in children with NAFLD and this impairment was independently associated with insulin resistance and hs-CRP. What is Known: • Pulmonary function tests (PFTs) abnormalities are common in adults with nonalcoholic fatty liver disease (NAFLD). • Studies involving PFTs abnormalities in pediatric NAFLD are lacking. What is New: • It is the first study that assessed PFT in pediatric patients with NAFLD. • PFTs abnormalities are present in children with NAFLD. • Insulin resistance and high sensitive C reactive protein are independently associated with the decline of PFTs in children with NAFLD.
肺功能测试（PFTs）与非酒精性脂肪性肝病（NAFLD）之间的关联已在成人研究中报道；然而，儿科研究缺乏。我们的研究旨在评估患有 NAFLD 的儿童的 PFTs。共有 137 名患有 NAFLD 的儿童和 100 名年龄和性别匹配的健康儿童纳入研究。对所有纳入的儿童进行了不同的 PFTs 测试，包括 1 秒用力呼气量（FEV1）、用力肺活量（FVC）、FEV1/FVC 比值、残气量（RV）和总肺容量（TLC）。测量了血脂谱、胰岛素抵抗、空腹和餐后血糖水平以及高敏 C 反应蛋白（hs-CRP）。与对照组相比，患者组的 FEV1%、FVC%、FEV1/FVC 比值、RV 和 TLC 明显降低（P<0.05），而 NAFLD 患儿的 RV 和 hs-CRP 明显升高。在患有 NAFLD 的儿童中，最常见的肺功能障碍是限制性肺功能障碍（21.9%）。PFT 指标与 NAFLD 的严重程度和持续时间、胰岛素抵抗、腰围和 hs-CRP 显著相关。回归分析显示，胰岛素抵抗和 hs-CRP 与 PFT 指数下降独立相关。结论：NAFLD 患儿的 PFT 指标受损，这种受损与胰岛素抵抗和 hs-CRP 独立相关。已知：• 肺功能测试（PFTs）异常在非酒精性脂肪性肝病（NAFLD）的成年人中很常见。• 涉及儿科 NAFLD 患者 PFT 异常的研究缺乏。新内容：• 这是第一项评估患有 NAFLD 的儿科患者 PFT 的研究。• NAFLD 儿童存在 PFT 异常。• 胰岛素抵抗和高敏 C 反应蛋白与儿童 NAFLD 患者 PFT 下降独立相关。
