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尿酸作为代谢功能障碍相关脂肪性肝病儿童和青少年心脏代谢风险的潜在标志物。

Uric acid as a potential marker of cardiometabolic risk in children and adolescents with metabolic dysfunction associated steatotic liver disease.

作者信息

Zdanowicz Katarzyna, Kopiczko Natalia, Flisiak-Jackiewicz Marta, Bobrus-Chociej Anna, Kowalczuk-Kryston Monika, Lebensztejn Dariusz M

机构信息

Department of Pediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Bialystok, Poland.

出版信息

Clin Exp Hepatol. 2024 Sep;10(3):188-193. doi: 10.5114/ceh.2024.143066. Epub 2024 Sep 30.

Abstract

AIM OF THE STUDY

The new term "metabolic dysfunction associated steatotic liver disease" (MASLD) focuses on the bidirectional interplay between fatty liver and metabolic dysregulation. The aim of this study was to evaluate serum concentrations of uric acid (UA) in overweight/obese children and adolescents and to determine the association of this parameter with MASLD and metabolic dysregulation.

MATERIAL AND METHODS

One hundred and ninety-four overweight/obese children with suspected liver disease were included in the study. MASLD was diagnosed according to the latest consensus. Diagnosis of metabolic syndrome (MetS) was based on the International Diabetes Federation criteria in children aged ≥ 10 years ( = 182).

RESULTS

MASLD was diagnosed in 68.56% and MetS in 26.92% of patients. Children with MASLD had significantly higher values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total cholesterol, triglycerides (TG), UA and carotid intima-media thickness (IMT). Significantly higher levels of insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and UA were observed in patients with MetS. Correlations were observed between UA and ALT, AST, GGT, TG, insulin, HOMA-IR, mean IMT, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) in overweight and obese children. UA was helpful in differentiating between children with MetS and without MetS ( = 0.0003), while only borderline statistical significance was observed for MASLD ( = 0.05).

CONCLUSIONS

Our results suggest that UA may be a potential additional and readily available marker of metabolic dysfunction in children with MASLD. Further studies on a larger group of patients are needed to confirm this association.

摘要

研究目的

新术语“代谢功能障碍相关脂肪性肝病”(MASLD)关注脂肪肝与代谢失调之间的双向相互作用。本研究的目的是评估超重/肥胖儿童及青少年的血清尿酸(UA)浓度,并确定该参数与MASLD及代谢失调之间的关联。

材料与方法

194名疑似患有肝病的超重/肥胖儿童被纳入本研究。MASLD根据最新共识进行诊断。代谢综合征(MetS)的诊断依据国际糖尿病联盟针对≥10岁儿童(n = 182)的标准。

结果

68.56%的患者被诊断为MASLD,26.92%的患者被诊断为MetS。患有MASLD的儿童丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、总胆固醇、甘油三酯(TG)、UA及颈动脉内膜中层厚度(IMT)的值显著更高。MetS患者的胰岛素、胰岛素抵抗稳态模型评估(HOMA-IR)及UA水平显著更高。在超重和肥胖儿童中,观察到UA与ALT、AST、GGT、TG、胰岛素、HOMA-IR、平均IMT、体重指数(BMI)及高密度脂蛋白胆固醇(HDL-C)之间存在相关性。UA有助于区分患有和未患有MetS的儿童(P = 0.0003),而对于MASLD仅观察到临界统计学意义(P = 0.05)。

结论

我们的结果表明,UA可能是MASLD儿童代谢功能障碍的一种潜在的额外且易于获得的标志物。需要对更大规模的患者群体进行进一步研究以证实这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d257/11650807/f360ea6d2611/CEH-10-54785-g001.jpg

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