肠道菌群失调对肥胖儿童非酒精性脂肪肝发生的影响

Effects of alteration of intestinal flora on the incidence of non-alcoholic fatty liver disease in obese children

目的观察肥胖儿童的肠道菌群失调、非酒精性脂肪肝发生情况,分析肠道菌群失调对肥胖儿童非酒精性脂肪肝发生的影响。方法选择2017年3月至2019年6月期间无锡市第九人民医院门诊肥胖儿童541例作为肥胖组,同期接受常规体检并证实为非肥胖且无其他严重合并症儿童112例作为对照组。设计一般情况调查问卷,记录研究对象的一般情况,全部儿童均接受肠道菌群检查,比较肥胖组与对照组肠道菌群失调、非酒精性脂肪性肝病发生情况,分析肠道菌群失调与肥胖儿童非酒精性脂肪肝之间的关系。结果肥胖组患儿BMI、腰围分别为(29.17±1.11)kg/m^2、(81.21±5.54)cm,均高于对照组,差异有统计学意义(P<0.05)。肥胖组肠杆菌、肠球菌菌落检出数分别为(8.62±1.33)、(7.49±1.11)高于对照组,其他菌落检出数低于对照组;肠道菌群失调、非酒精性脂肪性肝病检出率(18.67%、9.43%)高于对照组,差异有统计学意义(P<0.05)。肠道菌群失调与非酒精性脂肪性肝病的发生呈正相关(r=0.673,P<0.05);肠道菌群失调的肥胖儿童非酒精性脂肪性肝病检出率(41.58%)高于正常者,差异有统计学意义(P<0.05);肠道菌群失调是肥胖儿童非酒精性肝病危险因素(OR=34.090,P<0.05)。结论肥胖儿童多伴肠道菌群失调,并与非酒精性脂肪性肝病的发生密切相关,肠道菌群失调可能是肥胖儿童非酒精性脂肪性肝病发生的危险因素,应引起临床重视,尽早发现并干预。

Objective To observes the incidence of alteration of intestinal flora and non-alcoholic fatty liver disease in obese children,and to analyze the effect of alteration of intestinal flora on the incidence of non-alcoholic fatty liver disease in obese children.Methods 541 obese children in the outpatient of hospital from March 2017 to June 2019 were selected as obese group,and 112 children who received regular physical examination and were confirmed to be non-obese and had no other serious complications during the same period were selected as control group.The general situations questionnaire was designed,and the general situations of the research subjects were asked and recorded.All children underwent intestinal flora examination.The incidence of alteration of intestinal flora and non-alcoholic fatty liver disease in obese group and control group were compared,and the relationship between alteration of intestinal flora and non-alcoholic fatty liver disease in obese children was analyzed.Results The body mass index(BMI)and waist circumference in obese group were[(29.17±1.11)kg/m^2,(81.21±5.54)cm],which were higher than those in control group(P<0.05);Compared with control group,the detected number of enteric bacilli and enterococcus colony in obese group was[(8.62±1.33),(7.49±1.11)],which was higher,and the detected number of other colonies was lower;The detection rate of alteration of intestinal flora and non-alcoholic fatty liver diseasewas(18.67%,9.43%),which was high(P<0.05);The alteration of intestinal flora was positively correlated with the incidence of non-alcoholic fatty liver disease(r=0.673,P<0.05);The detection rate of non-alcoholic fatty liver disease in obese children with alteration of intestinal flora was(41.58%),which was higher than that in normal people(P<0.05);The alteration of intestinal flora was the risk factor for non-alcoholic fatty liver disease in obese children(OR=34.090,P<0.05).Conclusion Obese children are often associated with alteration of intestinal flora,which is closely related to the occurrence of non-alcoholic fatty liver disease.Alteration of intestinal flora may be the risk factor for the occurrence of non-alcoholic fatty liver disease in obese children,and it should be paid clinical attention to detect and intervene as soon as possible.