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唐氏综合征患儿代谢功能障碍相关肝病和胆石症:一项回顾性研究。

Metabolic dysfunction-associated liver disease and biliary lithiasis in children with Down Syndrome: a retrospective study.

作者信息

Nisihara Renato, Fuga Nayane Hiba, Maia Liete, Mansur Marcelo Gasparin, Liberatti Fernanda, Rossasi Maiana, Oliveira Nanci

机构信息

Universidade Positivo, Curitiba, PR, Brazil.

Universidade Federal do Paraná, Curitiba, PR, Brazil.

出版信息

Rev Paul Pediatr. 2025 Jan 17;43:e2024130. doi: 10.1590/1984-0462/2025/43/2024130. eCollection 2025.

Abstract

OBJECTIVE

To investigate the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) and gallbladder abnormalities in a sample of people with Down syndrome in Brazil.

METHODS

This is a retrospective study using medical charts involving Down syndrome patients, diagnosed by karyotype, aged over 5 years, who underwent abdominal ultrasound and were monitored by the same professional in a clinic in Curitiba, Brazil. Data spanned January 1995 to September 2023; all cases with no use of alcohol or hepatotoxic medications.

RESULTS

A total of 124 patients were evaluated, 64 (51.6%) being females. Ages varied between 5 and 30 years (average of 13.2±5.7 years). Body mass index ranged from 14.08 to 44.98 kg/m2, with 27 (21.7%) patients being overweight and 42 (33.8%) obese. The frequency of increased total cholesterol and triglyceride concentrations was significantly higher in children. No age or sex differences were seen in low- and high-density lipoprotein cholesterol. Alanine transferase (ALT) and aspartate transferase (AST) levels were within normal ranges and showed no differences concerning sex or age. Four patients (3.2%) had diagnosis of MAFLD. The prevalence of gallstone varied widely in terms of the number and size of stones among patients, affecting 11 (8.9%) of them, with no significant difference in age or sex.

CONCLUSIONS

MAFLD was found in 3.2% of the individuals, while gallstone disease was identified in 8.9% of the cases studied. Moreover, we noted a significant presence of risk factors associated with MAFLD, with dyslipidemia being the predominant factor.

摘要

目的

调查巴西唐氏综合征患者样本中代谢功能障碍相关脂肪性肝病(MAFLD)和胆囊异常的情况。

方法

这是一项回顾性研究,使用涉及唐氏综合征患者的病历,这些患者经核型诊断,年龄超过5岁,接受了腹部超声检查,并由巴西库里蒂巴一家诊所的同一名专业人员进行监测。数据涵盖1995年1月至2023年9月;所有病例均未使用酒精或肝毒性药物。

结果

共评估了124例患者,其中64例(51.6%)为女性。年龄在5至30岁之间(平均13.2±5.7岁)。体重指数范围为14.08至44.98kg/m²,27例(21.7%)患者超重,42例(33.8%)肥胖。儿童总胆固醇和甘油三酯浓度升高的频率显著更高。在低密度和高密度脂蛋白胆固醇方面未观察到年龄或性别差异。丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)水平在正常范围内,且在性别或年龄方面无差异。4例患者(3.2%)诊断为MAFLD。胆结石的患病率在患者之间的结石数量和大小方面差异很大,11例(8.9%)患者受影响,在年龄或性别方面无显著差异。

结论

在3.2%的个体中发现了MAFLD,而在所研究的病例中,8.9%的病例发现了胆结石疾病。此外,我们注意到与MAFLD相关的危险因素大量存在,血脂异常是主要因素。

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