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儿童肥胖相关指标与非酒精性脂肪性肝病的关系：一项系统评价和荟萃分析。

Relationship between obesity related indicators and non-alcoholic fatty liver disease in children: a systematic review and meta-analysis.

作者信息

He Ying, Cao Liubin, Zhou Chengpei, Zhang Rupei, Zeng Mingwei, Peng Xiaoqing, Sun Xiaolei, Yan Jun

机构信息

Department of Forensic Medicine, Medical School, Nantong University, Nantong, China.

Department of Pathogenic Biology, Medical School of Nantong University, Nantong, China.

出版信息

Transl Pediatr. 2023 Mar 31;12(3):429-444. doi: 10.21037/tp-23-123. Epub 2023 Mar 28.

DOI:10.21037/tp-23-123
PMID:37035402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10080478/
Abstract

BACKGROUND

The incidence of childhood obesity is increasing. There is some controversy about the association between overweight and nonalcoholic fatty liver disease (NAFLD) in children. This article intends to compare the differences in these obesity related parameters between NAFLD children and healthy control children through meta-analysis to provide evidence-based medical evidence for clinical use.

METHODS

The literature were extracted from English and Chinese databases. Statistical analysis was performed using Stata/SE 16.0, IBM SPSS Statistics 26, and Review Manager 5.4 software.

RESULTS

A total of 15 original case control studies were included, including 12 high-quality literature, 3 medium quality literature. The total sample size included in the analysis was 1,595 children, including 824 in the experimental group and 771 in the control group. The results of meta-analysis showed that the body mass index (BMI) of the NAFLD group was significantly higher than that of the control group [mean difference (MD) =1.05, 95% confidence interval (CI): 0.36-1.73]. Waist circumference of the NAFLD group was significantly larger than that of the control group (MD =1.66, 95% CI: 0.60-2.73). Triglyceride level in the NAFLD group was significantly higher than that in the control group (MD =1.08, 95% CI: 0.05-2.12). Low-density lipoprotein (LDL) level in the NAFLD group was significantly higher than that in the control group (MD =0.49, 95% CI: 0.12-0.85). In addition, fasting blood glucose of the NAFLD group was significantly higher than that of the control group (MD =0.31, 95% CI: 0.09-0.54) and insulin resistance index of the NAFLD group was significantly higher than that of the control group (MD =2.95, 95% CI: 1.41-4.49). Exercise had a significant effect on improving the degree of NAFLD in children [odds ratio (OR) =2.51, 95% CI: 1.83-3.43].

CONCLUSIONS

Various physical indicators were related to obesity, including BMI, waist circumference, triglyceride content, LDL, fasting blood glucose, and insulin resistance index, and all were significantly correlated with NAFLD in children, provided a reference for future clinical diagnosis and treatment work. In addition, exercise could significantly improve the degree of steatosis in children with NAFLD.

摘要

背景

儿童肥胖症的发病率正在上升。儿童超重与非酒精性脂肪性肝病（NAFLD）之间的关联存在一些争议。本文旨在通过荟萃分析比较NAFLD儿童与健康对照儿童在这些肥胖相关参数上的差异，为临床应用提供循证医学证据。

方法

从英文和中文数据库中提取文献。使用Stata/SE 16.0、IBM SPSS Statistics 26和Review Manager 5.4软件进行统计分析。

结果

共纳入15项原始病例对照研究，其中高质量文献12篇，中等质量文献3篇。分析纳入的总样本量为1595名儿童，其中实验组824名，对照组771名。荟萃分析结果显示，NAFLD组的体重指数（BMI）显著高于对照组[平均差（MD）=1.05，95%置信区间（CI）：0.36 - 1.73]。NAFLD组的腰围显著大于对照组（MD =1.66，95% CI：0.60 - 2.73）。NAFLD组的甘油三酯水平显著高于对照组（MD =1.08，95% CI：0.05 - 2.12）。NAFLD组的低密度脂蛋白（LDL）水平显著高于对照组（MD =0.49，95% CI：0.12 - 0.85）。此外，NAFLD组的空腹血糖显著高于对照组（MD =0.31，95% CI：0.09 - 0.54），NAFLD组的胰岛素抵抗指数显著高于对照组（MD =2.95，95% CI：1.41 - 4.49）。运动对改善儿童NAFLD程度有显著作用[比值比（OR）=2.51，95% CI：1.83 - 3.43]。

结论

多种身体指标与肥胖相关，包括BMI、腰围、甘油三酯含量、LDL、空腹血糖和胰岛素抵抗指数，且均与儿童NAFLD显著相关，为未来临床诊断和治疗工作提供了参考。此外，运动可显著改善NAFLD儿童的脂肪变性程度。

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