肥胖儿童非酒精性脂肪肝影响因素分析

Study on Influencing Factors of Nonalcoholic Fatty Liver in Obesity Children

目的了解肥胖儿童非酒精性脂肪肝的流行现状和危险因素,发现肥胖儿童脂肪肝的高危人群。方法对117例6～14岁肥胖儿童青少年进行体格测量和空腹抽血进行肝功能、血脂、血糖、血清胰岛素水平和C肽等方面的检测,同时空腹进行腹部B超检查,根据B超结果分为脂肪肝组和非脂肪肝组。统计方法包括t检验和χ2检验和Logistic回归分析。结果在117名儿童中,共检出脂肪肝患儿45例,检出率38.5%;其中男生中检出40例,检出率44.4%;女生中检出5例,检出率18.5%。(2)多因素Logistic回归分析显示肥胖儿童非酒精性脂肪肝独立的危险因素有5个,分别为性别(RR=0.022,P=0.010)、BMI值(RR=1.357,P=0.010)、腰围(RR=9.004,P=0.036)、ALT(RR=1.059,P=0.005)和血清胰岛素水平(RR=1.141,P=0.026)。结论肥胖儿童伴有脂肪肝者较普遍;肥胖儿童脂肪肝与性别、肥胖程度及类型、肝脏功能受损和高胰岛素水平密切相关。

Objective To study the prevalence and influencing factors of nonalcoholic fatty liver in obesity children,so as to find out the subpopulation at higher risk.Methods A total of 117 obesity children aged 6-14 years were recruited.All of the research objects received physical examination and abdominal B-ultrasound examination.Blood was collected for liver function test and determination of blood lipid,blood glucose,serum insulin and C-peptide.They were assigned into fatty liver group and non-fatty liver group according to the results of abdominal B-ultrasound examination for data analysis by t-test,Chi-square test and Logistic regression analysis.Results Totally,45 out of 117（38.5%） obesity children were found to have fatty livers.The detection rate of fatty liver in boys was 44.4%（40/90） and 18.5% in girls（5/27）.Logistic regression analysis indicated that the independent risk factors of nonalcoholic fatty liver in obesity children included gender（RR=0.022,P=0.010）,BMI（RR=1.357,P=0.010）,waist circumference（RR=9.004,P=0.036）,serum ALT（RR=1.059,P=0.005）and serum insulin level（RR=1.141,P=0.026）.Conclusions Fatty liver is popular in obesity children.Gender,obesity degree and pattern,liver function injury and higher serum insulin are closely associated with nonalcoholic fatty liver in obesity children.