Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310051, China.
National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Hepatol Int. 2024 Feb;18(1):179-187. doi: 10.1007/s12072-023-10596-9. Epub 2023 Oct 20.
Previous studies have reported sex differences in non-alcoholic fatty liver disease (NAFLD) among adults; however, little is known about its occurrence in children and adolescents. This study aims to examine the prevalence of NAFLD among them and investigate the relationship between sex hormones and NAFLD.
This study included 2999 obese Chinese children aged 2-18 years. We examined the prevalence of NAFLD by sex, age, and Tanner stage. The regression model and principal component analysis were used to analyze the relationship between sex hormones and NAFLD.
The prevalence of NAFLD increased with age in both sexes, and the gender difference appeared before puberty. The prevalence in boys tended to stabilize at the age of 11 years, whereas girls reached their peak temporarily. NAFLD prevalence was positively associated with estradiol in boys (p = 0.011), but the opposite trend was observed in girls (p = 0.031). Testosterone levels decreased with the increase of NAFLD prevalence in boys (p < 0.001). Luteinizing hormone and prolactin were inversely associated with NAFLD prevalence in boys and girls, respectively. Results from the principal component analysis showed that sex hormone levels and fat distribution were important risk factors for the prevalence of NAFLD in obese children (p < 0.001).
The significant difference in NAFLD prevalence between genders in obese children begins in early childhood. This distinction emerges long before puberty onset and tends to stabilize during late adolescence. Sex hormones are associated with NAFLD prevalence and are influenced by the Tanner stages and fat distribution.
先前的研究报告称,非酒精性脂肪性肝病(NAFLD)在成年人中存在性别差异;然而,关于其在儿童和青少年中的发生情况知之甚少。本研究旨在检查肥胖的中国儿童中 NAFLD 的患病率,并探讨性激素与 NAFLD 之间的关系。
本研究纳入了 2999 名 2-18 岁肥胖的中国儿童。我们通过性别、年龄和 Tanner 分期检查了 NAFLD 的患病率。采用回归模型和主成分分析来分析性激素与 NAFLD 之间的关系。
NAFLD 的患病率在两性中均随年龄增长而增加,且性别差异在青春期前出现。男孩的患病率在 11 岁左右趋于稳定,而女孩则暂时达到峰值。NAFLD 患病率与男孩的雌二醇呈正相关(p=0.011),但在女孩中则呈现相反的趋势(p=0.031)。男孩的睾丸酮水平随着 NAFLD 患病率的增加而降低(p<0.001)。黄体生成素和催乳素分别与男孩和女孩的 NAFLD 患病率呈负相关。主成分分析的结果表明,性激素水平和脂肪分布是肥胖儿童 NAFLD 患病率的重要危险因素(p<0.001)。
肥胖儿童中 NAFLD 患病率的性别差异始于幼儿期。这种差异早在青春期前就出现了,并在青春期后期趋于稳定。性激素与 NAFLD 患病率相关,并受 Tanner 分期和脂肪分布的影响。