Ye P, Gao L, Xia Z, Peng L, Shi X, Ma J, Dong Y, Dai D, Yang Q, Chen X, Fan X, Wan N, Zhang J, Li B, Zhou L, Wu G, Yang L, Li X, Yan Y, He Y
School of Public Health, Capital Medical University, Beijing, China; Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
School of Public Health, Capital Medical University, Beijing, China.
Public Health. 2024 Oct;235:160-166. doi: 10.1016/j.puhe.2024.06.004. Epub 2024 Aug 13.
Both obesity and non-alcoholic fatty liver disease (NAFLD) increase the risk of metabolic abnormalities. However, the metabolic status of children suffering from NAFLD and exhibiting various subtypes of obesity is currently unclear. We aimed to explore the association between NAFLD and metabolic abnormalities in children with different weight statuses.
We included 6086 participants aged 6-18 years from the China Child and Adolescent NAFLD Study (CCANS), all of whom had undergone ultrasonography or magnetic resonance imaging-proton density fat fraction (MRI-PDFF) to identify NAFLD and metabolic abnormalities, including hyperglycemia, high triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol, high total cholesterol, and hyperuricemia.
Among the participants, there were 2408 children with obesity and NAFLD, 174 with NAFLD, 2396 with obesity, and 1108 without obesity and NAFLD. The odds ratios (ORs) of suffering from individual metabolic abnormalities were significantly greater in children with obesity and NAFLD than in children without obesity and NAFLD, with ORs ranging from 6.23 (95% CI: 4.56, 8.53) to 1.77 (95% CI: 1.06, 2.94). The ORs of metabolic abnormalities, except for low HDL-C, were greater in children with NAFLD alone than in children without obesity or NAFLD, with ORs ranging from 4.36 (95% CI: 2.77, 6.84) to 2.08 (95% CI: 1.14, 3.78). Notably, obesity and NAFLD had a multiplicative effect on overall metabolic abnormalities, high TG levels, and low HDL-C levels.
Children with obesity and NAFLD could be at a significantly increased risk of metabolic abnormalities. Even for children without obesity, NAFLD appears to be associated with an increased risk of experiencing a worsened metabolic status.
肥胖和非酒精性脂肪性肝病（NAFLD）均会增加代谢异常的风险。然而，目前尚不清楚患有NAFLD且表现出各种肥胖亚型的儿童的代谢状况。我们旨在探讨不同体重状态的儿童中NAFLD与代谢异常之间的关联。
我们纳入了来自中国儿童和青少年NAFLD研究（CCANS）的6086名6至18岁的参与者，他们均接受了超声检查或磁共振成像-质子密度脂肪分数（MRI-PDFF）以确定NAFLD和代谢异常，包括高血糖、高甘油三酯（TG）、低高密度脂蛋白胆固醇（HDL-C）、高低密度脂蛋白胆固醇、高总胆固醇和高尿酸血症。
在参与者中，有2408名肥胖且患有NAFLD的儿童，174名患有NAFLD的儿童，2396名肥胖儿童，以及1108名既不肥胖也不患有NAFLD的儿童。肥胖且患有NAFLD的儿童患个体代谢异常的比值比（OR）显著高于既不肥胖也不患有NAFLD的儿童，OR范围为6.23（95%CI：4.56，8.53）至1.77（95%CI：1.06，2.94）。除低HDL-C外，仅患有NAFLD的儿童的代谢异常OR高于既不肥胖也不患有NAFLD的儿童，OR范围为4.36（95%CI：2.77，6.84）至2.08（95%CI：1.14，3.78）。值得注意的是，肥胖和NAFLD对总体代谢异常、高TG水平和低HDL-C水平具有相乘效应。
肥胖且患有NAFLD的儿童代谢异常风险可能会显著增加。即使对于不肥胖的儿童，NAFLD似乎也与代谢状况恶化风险增加有关。
