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超重/肥胖儿童非酒精性脂肪性肝病患病率及影响因素的横断面研究

[A cross-sectional study on the prevalence rate and influencing factors of non-alcoholic fatty liver disease in overweight/obese children].

作者信息

Dai Wen, Yao Zhen-Zhen, Ou-Yang Si-Si, Xu Ning-An, Zhou Hai-Xiang, Li Xiong-Wei, Zhong Yan, Luo Jia-You

机构信息

Department of Maternal and Child Health Care, Xiangya School of Public Health, Central South University, Changsha 410078, China.

Children's Health Center, Hunan Children's Hospital, Changsha 410007, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 May 15;25(5):448-456. doi: 10.7499/j.issn.1008-8830.2211018.

Abstract

OBJECTIVES

To investigate the prevalence rate of non-alcoholic fatty liver disease (NAFLD) in overweight/obese children who visit a hospital, and to explore the influencing factors of NAFLD, in order to provide a basis for the prevention of NAFLD in overweight/obese children.

METHODS

Overweight/obese children who visited Hunan Children's Hospital from June 2019 to September 2021 were recruited. The prevalence rate of NAFLD was examined. Logistic regression analysis was used to explore the factors influencing the development of NAFLD [non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH)]. Receiver operating characteristic curve analysis was used to evaluate the predictive value of the influencing factors for NAFL and NASH.

RESULTS

A total of 844 overweight/obese children aged 6-17 years were enrolled. The prevalence rate of NAFLD in overweight/obese children was 38.2% (322/844), among which the prevalence rates of NAFL and NASH were 28.8% (243/844) and 9.4% (79/844), respectively. Multivariate logistic regression analysis showed that the increase of waist-to-hip ratio (WHR) and low high-density lipoprotein cholesterol (HDL-C) were associated with the development of NAFL and NASH (<0.05). The receiver operating characteristic curve analysis showed that the combined measurement of WHR and HDL-C had a predictive value for NAFL (area under the curve: 0.653, 95%: 0.613-0.694), and for NASH (area under the curve: 0.771, 95%: 0.723-0.819).

CONCLUSIONS

The prevalence rate of NAFLD in overweight/obese children who visit a hospital is high. WHR and HDL-C are associated with the development of NAFLD and the combined measurement of WHR and HDL-C has a certain value for predicating the development of NAFLD.

摘要

目的

调查前来医院就诊的超重/肥胖儿童中非酒精性脂肪性肝病(NAFLD)的患病率,并探讨NAFLD的影响因素,为超重/肥胖儿童NAFLD的预防提供依据。

方法

招募2019年6月至2021年9月期间在湖南省儿童医院就诊的超重/肥胖儿童。检测NAFLD的患病率。采用Logistic回归分析探讨影响非酒精性脂肪肝(NAFL)和非酒精性脂肪性肝炎(NASH)发生发展的因素。采用受试者工作特征曲线分析评估影响因素对NAFL和NASH的预测价值。

结果

共纳入844名6 - 17岁的超重/肥胖儿童。超重/肥胖儿童中NAFLD的患病率为38.2%(322/844),其中NAFL和NASH的患病率分别为28.8%(243/844)和9.4%(79/844)。多因素Logistic回归分析显示,腰臀比(WHR)升高和高密度脂蛋白胆固醇(HDL-C)降低与NAFL和NASH的发生发展相关(<0.05)。受试者工作特征曲线分析显示,WHR与HDL-C联合检测对NAFL具有预测价值(曲线下面积:0.653,95%:0.613 - 0.694),对NASH也具有预测价值(曲线下面积:0.771,95%:0.723 - 0.819)。

结论

前来医院就诊的超重/肥胖儿童中NAFLD的患病率较高。WHR和HDL-C与NAFLD的发生发展相关,WHR与HDL-C联合检测对预测NAFLD的发生发展具有一定价值。

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