肥胖儿童非酒精性脂肪肝的肝酶检测意义及与血脂的关系

The significance of liver enzymes in obese children with nonalcoholic fatty liver and its relationship with lipid

目的:探讨肝酶在儿童肥胖非酒精性脂肪肝病的检测意义及与血脂、体格测量指标的关系。方法:对79例肥胖儿童(伴有非酒精性脂肪肝58例和无非酒精性脂肪肝21例)和93例正常儿童(对照组)进行体格检查;检测血谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL);肥胖儿童行肝脏超声检查。结果:79例肥胖儿童体重、体质量指数(BMI)、腰围、臀围、腰臀比、ALT、TC、TG、LDL高于对照组,HDL低于对照组(P<0.05);非酒精性脂肪肝组ALT、AST、ALT/AST>1的发生率、TG、体重、BMI、腰围高于无非酒精性脂肪肝组(P<0.05或P<0.01);经二分类非条件Logis-tic回归分析,ALT、TG、BMI与儿童非酒精性脂肪肝相关联。结论:ALT、AST的升高是预示非酒精性脂肪肝的敏感指标;TG、肥胖程度和腹型肥胖与非酒精性脂肪肝相关;ALT、TG、BMI的升高可能是肥胖儿童患非酒精性脂肪肝的独立危险因素。

Objective： To research on the significance of liver enzymes in obese children with nonalcoholic fatty liver disease and its relationship with lipid and physical development. Methods： 79 obese children （with nonalcoholic fatty liver in 58 cases, without nonalcoholic fatty liver in 21 cases） and 93 normal children （control group） were for physical examination;alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total cholesterol （TC）, triglyceride （TG）,low density lipoprotein （LDL）, high density lipoprotein （HDL） of both group were detected and the liver was examined with ultrasound in obese children. Results： Weight, BMI, waist circumference, hip circumference,WHR,ALT,TC,TG,LDL in obese children were higher,HDL were lower than these in the control group （P 〈0.05）;ALT, AST, the incidence of ALT/AST〉 1, TG, weight, BMI, waist circumference nonalcoholic fatty liver group were higher than these in without nonalcoholic fatty liver group （P〈0.05 or P〈0.01）;the two categories of non-classified Logistic regression analysis suggested that ALT, TG, BMI were related to nonalcoholic fatty liver. Conclusion： The elevation of ALT, AST is a sensitive indicator to indicate NAFLD; TG, obesity, and abdominal obesity are related to nonalcoholic fatty liver; the increase of ALT,TG, BMI in obese children may be nonalcoholic fatty liver independent risk factors.