Di Sessa Anna, Guarino Stefano, Umano Giuseppina Rosaria, Arenella Mattia, Alfiero Salvatore, Quaranta Gaetano, Miraglia Del Giudice Emanuele, Marzuillo Pierluigi
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, 80138 Napoli, Italy.
Children (Basel). 2021 Mar 23;8(3):247. doi: 10.3390/children8030247.
Recently, the new definition of Metabolic (dysfunction) associated fatty liver disease (MAFLD) has gained remarkable scientific interest. We aimed to evaluate the effectiveness of MAFLD definition in selecting obese children at higher cardiovascular risk.
A total of 954 obese children and adolescents was retrospectively enrolled. Clinical, biochemical, and metabolic evaluations were performed. Hepatic steatosis was assessed by liver ultrasound. According to the metabolic status, the population was divided in three groups. Group 1 included obese patients without both non-alcoholic fatty liver disease (NAFLD) and metabolic dysregulation; group 2 included patients with obesity and NAFLD (then encompassing one MAFLD criterion); group 3 included patients with obesity, NAFLD and evidence of metabolic dysregulation (then encompassing more than 1 MAFLD criteria).
Patients of Group 3 showed a worse cardiometabolic profile, as also proven by the higher percentage of prediabetes (defined as the presence of impaired fasting glucose or impaired glucose tolerance) compared to other groups ( = 0.001).
MAFLD criteria in obese children seem to be less accurate in identifying patients having an intrinsic higher cardiometabolic risk. This suggests the need for a more accurate definition in the context of pediatric obesity.
最近，代谢（功能障碍）相关脂肪性肝病（MAFLD）的新定义引起了科学界的极大兴趣。我们旨在评估MAFLD定义在筛选心血管疾病风险较高的肥胖儿童方面的有效性。
回顾性纳入954名肥胖儿童和青少年。进行了临床、生化和代谢评估。通过肝脏超声评估肝脂肪变性。根据代谢状况，将研究对象分为三组。第1组包括既无非酒精性脂肪性肝病（NAFLD）也无代谢失调的肥胖患者；第2组包括肥胖且患有NAFLD的患者（符合一项MAFLD标准）；第3组包括肥胖、患有NAFLD且有代谢失调证据的患者（符合一项以上MAFLD标准）。
第3组患者的心脏代谢状况较差，与其他组相比，糖尿病前期（定义为空腹血糖受损或糖耐量受损）的比例更高也证实了这一点（P = 0.001）。
MAFLD标准在识别具有较高内在心脏代谢风险的肥胖儿童方面似乎不太准确。这表明在儿童肥胖背景下需要更准确的定义。
