Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?
Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?
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DOI：
10.3967/0895-3988.2011.01.003
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发表时间：
2011-02-01
影响因子：
3.5
通讯作者：
Mi Jie
中科院分区：
文献类型：
--
作者：
Meng LingHui;Luo Na;Mi Jie
目的探讨肥胖类型和程度对中国学龄儿童非酒精性脂肪性肝病（NAFLD）及相关血脂紊乱的影响。于2007年3月至5月收集了体重、身高、腰围等人体测量数据。计算体重指数（BMI）。采集血液样本，测定血脂，包括甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C），同时测定谷丙转氨酶（ALT）和谷丙转氨酶（AST）以评估肝功能。还通过超声扫描肝脏，并记录异常肝脏超声图。根据中华医学会肝病分会脂肪肝和酒精性肝病研究组推荐的标准诊断NAFLD。结果随着BMI或腰围的增加，血脂异常和超声脂肪肝的程度加重。与BMI相比，腰围对血脂异常、脂肪肝和NAFLD的发生有更大的影响。混合性肥胖组TG、TC、LDL-C水平最高，HDL-C水平最低，腹型肥胖组次之，周围型肥胖组最低，非肥胖组最低。经性别、年龄校正后，周围型肥胖、腹型肥胖和混合型肥胖的OR值分别为0，10.93（0.98-121.96）和79.16（10.95-572.44）预测NAFLD; 12.61（1.24-127.78）、19.39（5.23-71.85）和93.21（29.56-293.90）预测超声脂肪肝;与非肥胖对照组相比，预测血脂异常分别为1.78（0.59-5.44）、3.01（1.91-4.77）和4.64（3.52-6.12）。结论中国学龄儿童血脂水平、NAFLD及血脂异常患病率随肥胖程度的增加而增加;与非肥胖对照组相比，混合型肥胖与NAFLD及血脂异常的相关性最强，其次为腹型肥胖和周围型肥胖。
Objective To explore the impacts of types and degree of obesity on non-alcoholic fatty liver disease (NAFLD) and related lipids disturbance in Chinese school-age children.Methods A total of 1 452 school-age Children of 7 to 17 years were recruited in Beijing with representative cluster sampling method. Data of anthropometric measurements including weight, height and waist circumference were collected from March to May of 2007. Body mass index (BMI) was calculated. Blood samples were obtained and lipid profiles including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured, while glutamate-pyruvate transaminase (ALT) and glutamic-oxalacetic transaminase (AST) were determined to evaluate liver function. The liver was also scanned by sonography, and abnormal hepatic sonograms were documented. NAFLD was diagnosed according to the criteria recommended by the Fatty Liver and Alcoholic Liver Disease Study Group under the Chinese Liver Disease Association. Analysis of covariance (ANOVA), Chi-square test for trend and binary logistic regression analysis were performed.Results The dyslipidemia and ultrasonographic fatty liver deteriorated with the degree of obesity defined either by BMI or waist circumference. Compared with BMI, waist circumference contributed more to the development of dyslipidemia, fatty liver and NAFLD. The highest levels of TG, TC, LDL-C, and lowest level of HDL-C were seen in the mixed obese group followed by abdominal obese, peripheral obese and non-obese ones. Adjusted for gender and age, the odds ratios (ORs) and their 95% confidence intervals of peripheral obesity, abdominal obesity and mixed obesity were 0, 10.93 (0.98-121.96) and 79.16 (10.95-572.44) for predicting NAFLD; 12.61 (1.24-127.78), 19.39 (5.23-71.85), and 93.21 (29.56-293.90) for predicting ultrasonographic fatty liver; 1.78 (0.59-5.44), 3.01 (1.91-4.77), and 4.64 (3.52-6.12) for predicting dyslipidemia, respectively compared with the non-obese control group. The trend of hazards over groups was statistically significant (P < 0.01).Conclusion The levels of lipid profile and the prevalence of NAFLD and dyslipidemia increased in parallel with the degree of obesity; As compared with the non-obese control, the mixed obesity had the strongest association with NAFLD and dyslipidemia, followed by abdominal obesity and peripheral obesity in Chinese school-age Children.