脂肪肝儿童的代谢特点和危险因素分析

Metabolic characteristics of fatty liver in children and risk factors

目的分析肥胖儿童并发脂肪肝的代谢特点和危险因素。方法搜集2014年1月至2016年12月在某三甲医院住院的肥胖儿童,通过肝脏B超检测,将肥胖儿童分成单纯肥胖组和肥胖合并脂肪肝组。计算身体质量指数(body mass index,BMI)和体内平衡模型胰岛素抵抗指数。结果一共186例患者纳入研究,单纯肥胖组和肥胖合并脂肪肝组均为93例。肥胖合并脂肪肝组的年龄、男性比例、BMI、腰围、空腹血糖、空腹胰岛素、体内平衡模型胰岛素抵抗指数和尿酸水平比单存肥胖组高,差异有统计学意义(P<0. 05)。年龄是肥胖儿童发生脂肪肝的危险因素(OR>1,P<0. 05)。结论单纯肥胖儿童的男性性别、年龄、BMI、腰围、体内平衡模型胰岛素抵抗指数、尿酸与其发生脂肪肝密切相关,其中年龄是肥胖儿童发生脂肪肝的独立危险因素。

Objective To identify the metabolic characteristics of the children of comorbidity of obesity and fatty liver and the factors that contribute to the comorbidity.Methods Firstly,186 obese children hospitalized in our center during the period from January 2014 to December 2016 were chosen as the subjects of study.They were then divided into two groups as per the Results from B-scan ultrasonography,namely,group A(n=93)consisting of those with obesity only,and group B(n=93)consisting of those with comorbidity of obesity and fatty liver.The body mass index(BMI)and homeostasis model insulin resistance index(HSMIRI)of both groups were then calculated.Results The age,the proportion of male subjects,the BMI,the waist circumstance index,the fasting blood-glucose index,the fasting insulin index,the HSMIRI and the level of uric acid as observed in group B were significantly higher than those in group A.The differences were statistically significant(P<0.05).Age was found to be an independent risk factor that resulted in the symptom of fatty liver(OR>1,P<0.05).Conclusions The male sex,age,BMI,waist circumstance,HSMIRI,uric acid level of obese children are closely correlated to the occurrence of fatty liver and age is an independent risk factor that causes fatty liver in obese children.