同龄同性别腰围第85百分位值对儿童非酒精性脂肪肝的预测价值

Relation between age and gender specify waist circumference and non-alcoholic fatty liver disease in children

【目的】了解在校学生（non-alcoholic fatty liver disease,NAFLD）检出率及腰围百分位值对儿童非酒精性脂肪肝NAFLD的预测价值。【方法】对上海市浦东新区6-14岁学生1 180名进行检查。所有学生采集人体测量指标（体重、身高、腰围、臀围）、体脂含量和肝脏超声。【结果】1 180名在校学生NAFLD发生率为2.1%（25/1 180）。男生NAFLD检出率远高于女生。体质指数正常学生NAFLD检出率仅为0.6%（6/934）,而超重和肥胖学生则分别为3%（4/137）和13.8%（15/109）。6-9岁和10-14岁女性/男性儿童腰围P85分别为63/70 cm和72/72 cm。同龄同性别腰围P85值对NAFLD诊断的敏感性和特异性分别为76.0%和86.9%。【结论】上海地区6-14岁在校儿童NAFLD总检出率为2.1%。同龄同性别腰围P85值可作为儿童NAFLD的早期预测指标。

[Objective] To evaluate the prevalence of non-alcoholic fatty liver disease（NAFLD） in school children in Shanghai and relationship between age and gender specify waist circumference and NAFLD. [Methods] A total of 1 180 students aged 6 - 14 years （9.0 - 1.9 ）y from two elementary schools in Pudong New Area of Shanghai were enrolled in this study. Anthropometrics data （height, body weight, waist circumference, hip circumference）, body fat and liver ultrasound were taken for each student. [ Results] The prevalence of NAFLD was 2. 1% （25/1 180）, among which, 18 students （1.5%） were slight fatty liver and 7 students （0.6%） were medium fatty liver. The prevalence of NAFLD for boys was obvious higher than that for girls. The incidence of NAFLD in students with normal BMI was 0.6% （5/934）, while it was 2.9o/00 （4/137） and 13.8% （15/109） in overweight and obese students. The 85th percentile of waist circumference was 53/70 cm for 6-~9 years old girls/boys and 72/72 cm for 10-14 years old girls/boys. The sensitivity and specificity of NAF-LD was 76.0% and 86.9% for 86th percentile of waist circumference. [Conclusions] The prevalence of NAFLD was 2.1% in 1 180 school students aged 6-14 years in Shanghai. Age and gender specify 85th percentile of waist circum- ference may be a possible predictive index for NAFLD in children.