儿童非酒精性脂肪性肝病的人体测量学和生物化学特征：系统评价和荟萃分析。

Τhe anthropometric and biochemical profile of pediatric non-alcoholic fatty liver disease: A systematic review and a meta-analysis.

机构信息

Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Department of Gastroenterology and Hepatology, General Hospital of Thessaloniki "G. Papanikolaou", Greece.

Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; 4(th) Department of Pediatrics, General Hospital of Thessaloniki, "Papageorgiou", Greece.

出版信息

Clin Nutr. 2022 Jan;41(1):105-121. doi: 10.1016/j.clnu.2021.11.016. Epub 2021 Nov 23.

DOI:10.1016/j.clnu.2021.11.016

PMID:34872045

Abstract

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and one of the leading indications for liver transplantation in adults. However, current screening methods are inadequate and are accompanied by several disadvantages. This meta-analysis aims to identify the anthropometrical and biochemical characteristics most commonly appearing in pediatric NAFLD that could contribute to the diagnosis of the disease in the every-day clinical setting.

METHODS

A systematic search was conducted in major electronic databases (MEDLINE, Scopus and Embase) up to 15th of August 2021. Primary outcome was the comparison of the anthropometric characteristics, whereas secondary outcomes were the comparisons of biochemical profile, lipid profile, and metabolic parameters in children with NAFLD compared with age-matched healthy controls. Quality assessment was performed with Newcastle-Ottawa Scale (NOS) and results were expressed as mean differences with 95% confidence intervals.

RESULTS

Sixty-four studies were included. Two different comparisons were designed regarding the body mass status. Statistically significant differences were demonstrated by comparing children with NAFLD vs lean/normal weighted controls in body weight (23.0 kg, 95% CI: 14.0-31.8, P < 0.00001), height (3.07 cm, 95% CI: 0.21-5.94, P = 0.04), ΒΜΙ (10 kg/m, 95% CI: 8.36-11.7, P < 0.00001) and waist circumference 25.8 cm (95% CI: 20.6-30.9, P < 0.00001) and by comparing children with NAFLD vs overweight/obese controls in weight (6.81 kg, 95% CI: 3.81-9.81), height (3.18 cm, 95% CI: 1.24 to 5.13, P = 0.001), BMI (2.19 kg/m, 95% CI: 1.76-2.62, P < 0.00001) and WC (7.35 cm, 95% CI: 6.20-8.49, P < 0.00001).

CONCLUSIONS

Anthropometrical and biochemical characteristics of children and adolescents with NAFLD are statistically significantly different compared to age-matched controls; these characteristics could be used to identify individuals at risk of developing NAFLD and related comorbidities.

摘要

背景与目的

非酒精性脂肪性肝病（NAFLD）是儿童中最常见的肝脏疾病，也是成年人进行肝移植的主要指征之一。然而，目前的筛查方法并不完善，且存在多种弊端。本荟萃分析旨在确定儿科 NAFLD 中最常见的人体测量学和生化特征，以有助于在日常临床环境中诊断该疾病。

方法

系统检索了主要电子数据库（MEDLINE、Scopus 和 Embase），检索时间截至 2021 年 8 月 15 日。主要结局是比较人体测量特征，次要结局是比较 NAFLD 患儿与年龄匹配的健康对照组的生化特征、血脂谱和代谢参数。采用 Newcastle-Ottawa 量表（NOS）进行质量评估，结果表示为均数差及其 95%置信区间。

结果

共纳入 64 项研究。针对体重状态进行了两项不同的比较。与体重正常/偏轻的对照组相比，NAFLD 患儿的体重（23.0kg，95%CI：14.0-31.8，P<0.00001）、身高（3.07cm，95%CI：0.21-5.94，P=0.04）、BMI（10kg/m，95%CI：8.36-11.7，P<0.00001）和腰围（25.8cm，95%CI：20.6-30.9，P<0.00001）差异有统计学意义；与超重/肥胖对照组相比，NAFLD 患儿的体重（6.81kg，95%CI：3.81-9.81）、身高（3.18cm，95%CI：1.24-5.13，P=0.001）、BMI（2.19kg/m，95%CI：1.76-2.62，P<0.00001）和腰围（7.35cm，95%CI：6.20-8.49，P<0.00001）差异亦有统计学意义。