Dietary and physical activity patterns in children with fatty liver
Dietary and physical activity patterns in children with fatty liver
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DOI：
10.1038/ejcn.2010.35
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发表时间：
2010-06-01
影响因子：
4.7
通讯作者：
Roberts, E. A.
中科院分区：
文献类型：
--
作者：
Mager, D. R.;Patterson, C.;Roberts, E. A.
目的：通过超声检测脂肪肝患儿的生活方式(饮食、体力活动、能量消耗)和代谢变量(胰岛素抵抗、氧化应激、炎症)。研究对象/方法：对38例5~19岁脂肪肝患儿进行体成分(无脂肪质量、体重指数z)、腰围、膳食摄入量和能量消耗的测定。实验室检查包括肝脏生化、C反应蛋白、肿瘤坏死因子-α、谷胱甘肽过氧化物酶、维生素E和红细胞谷胱甘肽。结果：38名儿童中有36名超重/肥胖，37名有腹型肥胖迹象。表现为空腹高胰岛素血症(n-15)、高甘油三酯血症(n-14)和低脂联素血症(5.5+/-1.9S.D.)。和胰岛素抵抗(胰岛素抵抗的稳态模型(HOMA-IR)和GT；3；n=21)。丙氨酸氨基转移酶(ALT)升高28例(43~556U/L，中位数为56)。一些炎症标志物升高，而抗氧化剂降低。饮食的特点是高饱和脂肪，低多不饱和脂肪，高果糖和蔗糖摄入量。果糖摄入量与胰岛素抵抗和血清脂联素降低独立相关，与血清ALT无关(P<；0.05)。血清ALT异常(P=0.006)和HOMA-IR升高与omega-3脂肪酸(C20：5(n-3)和C22：6(n-3))摄入量低或低于正常有关。在11岁的儿童中也有类似的发现。结论：超声检查发现脂肪肝患儿具有非酒精性脂肪性肝病的代谢特征。他们的饮食中果糖含量高，多不饱和脂肪酸含量低。它们的活动模式是久坐不动的。这些生活方式特征可能会导致肝脏损伤，并可能成为治疗干预的重点。《欧洲临床营养学杂志》(2010年)，628-635；doi：10.1038/ejcn.2010.35；2010年3月10日在线出版
Background/Objectives: To examine lifestyle patterns (diet, physical activity, energy expenditure) and metabolic variables (insulin resistance, oxidative stress, inflammation) in children with fatty liver detected by sonography.Subjects/Methods: Body composition (fat-free mass, body mass index-z), waist circumference (WC), dietary intake and energy expenditure were determined in 38 patients (ages 5-19 years) with fatty liver in whom specific causative liver disorders had been excluded. Laboratory investigations included liver biochemistries, C-reactive protein, tumor necrosis factor-alpha, glutathione peroxidase, vitamin E, and erythrocyte-glutathione.Results: In all, 36 of 38 children were overweight/obese; 37 had WC indicative of abdominal obesity. They displayed fasting hyperinsulinemia (n - 15), hypertriglyceridemia (n - 14), and hypoadiponectinemia (5.5 +/- 1.9 s.d. mu g/ml; n - 23) and insulin resistance (homeostasis model of insulin resistance (HOMA-IR) > 3; n = 21). Alanine aminotransferase (ALT) was elevated in 28 (43-556 U/l; median = 56). Some inflammatory markers were elevated, whereas antioxidants were decreased. Diet was characterized by high saturated-, low polyunsaturated-fat, high fructose and sucrose intakes. Fructose intake was independently associated with insulin resistance and decreased serum adiponectin, regardless of serum ALT (P < 0.05). Low and subnormal intakes of omega-3 fatty acids (C20:5 (n-3) and C22:6 (n-3)) were associated with abnormal serum ALT (P = 0.006) and elevated HOMA-IR (P = 0.01). Findings were similar in children 11 years old. Physical activity was low in both age groups.Conclusions: Children with fatty liver detected sonographically have metabolic features of non-alcoholic fatty liver disease. Their diets are high in fructose and low in polyunsaturated fatty acid. Their activity patterns are sedentary. These lifestyle features may contribute to liver damage and can be a focus for therapeutic intervention. European Journal of Clinical Nutrition (2010) 64, 628-635; doi:10.1038/ejcn.2010.35; published online 10 March 2010