Gender-Specific Prevalences of Fatty Liver in Obese Children and Adolescents: Roles of Body Fat Distribution, Sex Steroids, and Insulin Resistance
Gender-Specific Prevalences of Fatty Liver in Obese Children and Adolescents: Roles of Body Fat Distribution, Sex Steroids, and Insulin Resistance
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DOI：
10.1210/jc.2009-1125
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发表时间：
2009-10-01
影响因子：
5.8
通讯作者：
Wabitsch, Martin
中科院分区：
文献类型：
--
作者：
Denzer, Christian;Thiere, Dorothee;Wabitsch, Martin
背景：非酒精性脂肪性肝病（NAFLD）在肥胖儿童中的患病率存在性别差异。关于肥胖青年NAFLD的预测因素的信息较少。目的：本研究的目的是检查患病率模式，并确定与NAFLD风险相关的临床和实验室标志物。设计：这是一项横断面研究。设置：研究设置为康复诊所。研究参与者：共532名8-19岁的肥胖受试者（291名女孩）参加了这项研究。主要测量：脂肪肝和内脏脂肪量通过超声测定。实验室检查包括血脂，脂联素，高敏C-反应蛋白，性类固醇，和口服葡萄糖耐量test.Results：肝脂肪变性的患病率是显着高于男孩（41.1%）比女孩（17.2%），是最高的青春期后的男孩（51.2%）和最低的青春期后的女孩（12.2%）。脂肪变性的严重程度与内脏脂肪量增加、胰岛素抵抗、脂联素水平降低和血压升高相关。通过主成分分析，从面板的调查参数中提取三个因素。Logistic回归分析显示，单纯性脂肪变性与“胰岛素抵抗和内脏脂肪”因素和“体脂分布和炎症”因素在两种性别和另外与“类固醇激素”因素在女孩显着相关。伴随ALT升高的脂肪肝的风险仅与“胰岛素抵抗和内脏脂肪”的女孩和所有三个因素在boy.Conclusion：我们的研究结果表明显着的NAFLD与标志物的内脏肥胖和胰岛素抵抗的性别和性别特异性协会与体脂分布和性类固醇的参数。（临床内分泌代谢杂志94：3872-3881，2009）
Context: Nonalcoholic fatty liver disease (NAFLD) is known to have a gender-dimorphic prevalence in obese children. Less information is available on predictive factors for NAFLD in obese youths.Objective: The aim of the study was to examine the prevalence pattern and to identify clinical and laboratory markers associated with the risk for NAFLD.Design: This was a cross-sectional study.Setting: The study setting was a rehabilitation clinic.Study Participants: A total of 532 obese subjects (291 girls) aged 8-19 yr participated in the study.Main Measurements: Steatosis hepatis and visceral fat mass were determined by ultrasound. Laboratory tests included serum lipids, adiponectin, high-sensitivity C-reactive protein, sex steroids, and an oral glucose tolerance test.Results: Prevalence of hepatic steatosis was significantly higher in boys (41.1%) than in girls (17.2%) and was highest in postpubertal boys (51.2%) and lowest in postpubertal girls (12.2%). Severity of steatosis was associated with increased visceral fat mass, insulin resistance, lower adiponectin levels, and higher blood pressure. Three factors were extracted from the panel of investigated parameters by principal component analysis. Logistic regression analysis revealed significant associations of simple steatosis with the "insulin resistance and visceral fat" factor and the "body fat distribution and inflammation" factor in both genders and additionally with the "steroid hormones" factor in girls. Risk for steatosis hepatis with concomitantly elevated ALT was associated only with "insulin resistance and visceral fat" in girls and with all three factors in boys.Conclusion: Our results suggest significant associations of NAFLD with markers of visceral obesity and insulin resistance in both genders and gender-specific associations with parameters of body fat distribution and sex steroids. (J Clin Endocrinol Metab 94: 3872-3881, 2009)