Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Eur J Clin Nutr. 2023 Dec;77(12):1167-1172. doi: 10.1038/s41430-023-01326-3. Epub 2023 Aug 16.
BACKGROUND/OBJECTIVE: Several body components are known to be associated with non-alcoholic fatty liver disease (NAFLD) in children. However, the relative contributions of soft tissue mass components as risk or protective factors of NAFLD are largely unknown because measurements of these components are often highly correlated. Therefore, we aimed to estimate levels of association between soft tissue mass components and NAFLD.
SUBJECTS/METHODS: We collected the medical records of 555 Chinese children (aged 3-18 years). Five mutually exclusive and exhaustive components of soft tissue mass were measured using dual energy X-ray absorptiometry. NAFLD was diagnosed with abdominal B-ultrasound scan. We fit Dirichlet regression and multivariate linear regression models wherein age and NAFLD were used as predictors of the proportional measurements of soft tissue mass components.
The proportion of android fat was significantly higher in children with NAFLD than in those without NAFLD (ratio of proportions ranged from 1.18 to 1.30), whereas proportions of trunk lean and limb lean were significantly lower (ratio of proportions ranged from 0.87 to 0.92 for trunk lean and from 0.82 to 0.91 for limb lean). The proportion of gynoid fat was slightly higher in boys with NAFLD than in those without NAFLD (ratio = 1.05), but this proportion was not significantly higher in girls. The association between the proportion of android fat and NAFLD appeared to be somewhat greater than the associations between proportions of trunk lean or limb lean components and NAFLD.
Our findings suggest that lowering fat mass and increasing lean mass can both be used to combat NAFLD in children and that more studies are needed to determine the association between gynoid fat and NAFLD.
背景/目的:已知一些身体成分与儿童非酒精性脂肪性肝病(NAFLD)有关。然而,由于这些成分的测量往往高度相关,因此软组织质量成分作为 NAFLD 的风险或保护因素的相对贡献在很大程度上是未知的。因此,我们旨在估计软组织质量成分与 NAFLD 之间的关联水平。
受试者/方法:我们收集了 555 名中国儿童(3-18 岁)的病历。使用双能 X 射线吸收法测量了 5 种互斥且详尽的软组织质量成分。使用腹部 B 超扫描诊断 NAFLD。我们拟合了 Dirichlet 回归和多变量线性回归模型,其中年龄和 NAFLD 被用作软组织质量成分比例测量的预测因子。
患有 NAFLD 的儿童的躯干脂肪比例明显高于无 NAFLD 的儿童(比例范围从 1.18 到 1.30),而躯干瘦组织和四肢瘦组织的比例明显较低(躯干瘦组织的比例范围从 0.87 到 0.92,四肢瘦组织的比例范围从 0.82 到 0.91)。患有 NAFLD 的男孩的臀部脂肪比例略高于无 NAFLD 的男孩(比例为 1.05),但女孩的比例没有明显升高。躯干脂肪比例与 NAFLD 之间的关联似乎比躯干瘦组织或四肢瘦组织成分与 NAFLD 之间的关联更为密切。
我们的研究结果表明,降低脂肪量和增加瘦组织量都可以用于治疗儿童的 NAFLD,需要更多的研究来确定臀部脂肪与 NAFLD 之间的关系。