Ko Hae-Jin, Woo Sarah, Han Junhee, Kim Yoon Myung, Lim Hyun Jung, Kim Min-Jeong, Park Yong Soon, Park Kyung Hee
Department of Family Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea.
Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea.
Obes Res Clin Pract. 2023 Jul-Aug;17(4):335-342. doi: 10.1016/j.orcp.2023.05.013. Epub 2023 Jun 17.
We aimed to evaluate the relationships between hepatic steatosis and various indices of obesity, and to identify the most useful index for the prediction of hepatic steatosis in children and adolescents with obesity.
A total of 226 children and adolescents with a mean body mass index (BMI) z-score of 2.65 and a mean age of 11.4 years were subjected to anthropometric and body composition measurements, laboratory testing, abdominal fat mass assessment, and hepatic fat accumulation by magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF). The participants were divided into quartiles according to the severity of their hepatic steatosis, and the presence of hepatic steatosis was defined using an MRI-PDFF ≥ 5%.
The multivariate ordinal regression analysis showed that the severity of hepatic steatosis was positively associated with BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio, fat mass, fat-free mass, visceral adiposity, and abdominal subcutaneous adiposity. Higher activities of liver enzymes and higher concentrations of triglyceride, C-reactive protein, fasting insulin, and leptin were associated with more severe hepatic steatosis, whereas high-density lipoprotein-cholesterol and adiponectin were negatively associated with hepatic steatosis. The indices of obesity with areas under the receiver operating characteristic curves (AUCs) > 0.8 for the prediction of hepatic steatosis were liver enzymes, visceral adipose tissue area, waist-to-hip ratio, and waist-to-height ratio.
The severity of hepatic steatosis significantly correlated with various indices of obesity and cardiometabolic markers in children and adolescents with obesity. The indices of abdominal obesity would be the most useful for the prediction of hepatic steatosis.
我们旨在评估肝脂肪变性与各种肥胖指标之间的关系，并确定预测肥胖儿童和青少年肝脂肪变性最有用的指标。
共有226名平均体重指数（BMI）z评分2.65且平均年龄11.4岁的儿童和青少年接受了人体测量和身体成分测量、实验室检测、腹部脂肪量评估以及通过磁共振成像衍生的质子密度脂肪分数（MRI-PDFF）评估肝脂肪堆积情况。参与者根据肝脂肪变性的严重程度分为四分位数，肝脂肪变性的存在定义为MRI-PDFF≥5%。
多变量有序回归分析显示，肝脂肪变性的严重程度与BMI、腰围、腰臀比、腰高比、脂肪量、去脂体重、内脏脂肪量和腹部皮下脂肪量呈正相关。肝酶活性较高以及甘油三酯、C反应蛋白、空腹胰岛素和瘦素浓度较高与更严重的肝脂肪变性相关，而高密度脂蛋白胆固醇和脂联素与肝脂肪变性呈负相关。预测肝脂肪变性的受试者工作特征曲线下面积（AUC）>0.8的肥胖指标为肝酶、内脏脂肪组织面积、腰臀比和腰高比。
肥胖儿童和青少年的肝脂肪变性严重程度与各种肥胖指标和心脏代谢标志物显著相关。腹部肥胖指标对预测肝脂肪变性最有用。
