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儿童和青少年肥胖与血脂异常及非酒精性脂肪肝的关系

The Relationship Between Lipid Profile and Non-alcoholic Fatty Liver Disease in Children and Adolescents with Obesity.

机构信息

Department of Child Health and Dıseases, Kastamonu Training and Research Hospital, Kastamonu, Turkey.

Department of Biostatistics, Kastamonu Faculty of Medicine, Kastamonu Training and Research Hospital, Kastamonu, Turkey.

出版信息

J Coll Physicians Surg Pak. 2022 May;32(5):591-595. doi: 10.29271/jcpsp.2022.05.591.

Abstract

OBJECTIVE

To determine the relationship between lipid profile and non-alcoholic fatty liver disease in obese children and adolescents.

STUDY DESIGN

A comparative cross-sectional study.

PLACE AND DURATION OF STUDY

Department of Pediatrics, Kastamonu Training and Research Hospital, Turkey, from March 2018 to April 2021.

METHODOLOGY

Clinical, laboratory and ultrasound findings of 290 children and adolescents diagnosed with obesity were analysed. Children and adolescents were divided into two groups as those who were diagnosed with NAFLD by ultrasonography (USG) and those who did not were diagnosed. Two groups were compared in terms of clinical and biochemical findings.

RESULTS

The body mass index (BMI), bodyweight for height (BWH), insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), free T4, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), hemoglobin A1c (HbA1c) and HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) levels were found to be significantly higher (p<0.05) in the children and adolescents with NAFLD In obese children and adolescents; there was a significant correlation between the increase in TC, LDL-C and TG levels in the blood and the development of NAFLD (p<0.05). Blood ALT level ≥37 U/L in obese boys and ≥23.5 U/L in obese girls was found to be a strong diagnostic biomarker in determining the presence of NAFLD.

CONCLUSION

In obese children and adolescents, there was a significant relationship between the increase in BWH and blood lipid levels, insulin resistance and the development of NAFLD. ALT had high specificity and sensitivity to predict non-alcoholic fatty liver disease.

KEY WORDS

Obesity, Children, Hepatosteatoz.

摘要

目的

探讨肥胖儿童和青少年血脂谱与非酒精性脂肪肝(NAFLD)的关系。

研究设计

一项对比性横断面研究。

地点和研究时间

土耳其卡斯塔莫努培训与研究医院儿科,2018 年 3 月至 2021 年 4 月。

方法

分析了 290 例肥胖儿童和青少年的临床、实验室和超声检查结果。根据超声(USG)诊断为 NAFLD 的结果将儿童和青少年分为两组,并比较两组的临床和生化指标。

结果

NAFLD 组儿童和青少年的体重指数(BMI)、身高体重指数(BWH)、胰岛素、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、游离 T4、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、糖化血红蛋白(HbA1c)和胰岛素抵抗指数(HOMA-IR)水平明显高于无 NAFLD 组(p<0.05)。在肥胖儿童和青少年中,血液 TC、LDL-C 和 TG 水平升高与 NAFLD 的发生有显著相关性(p<0.05)。肥胖男孩的血 ALT 水平≥37 U/L,肥胖女孩的血 ALT 水平≥23.5 U/L 是诊断 NAFLD 的强有力的生物标志物。

结论

在肥胖儿童和青少年中,BWH 和血脂水平升高、胰岛素抵抗与 NAFLD 的发生有显著相关性。ALT 对预测非酒精性脂肪性肝病具有较高的特异性和敏感性。

关键词

肥胖症;儿童;肝脂肪变性

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