Non-alcoholic fatty liver disease:An early mediator predicting metabolic syndrome in obese children?  

作　　者：Jun-Fen Fu Hong-Bo Shi Li-Rui Liu Ping Jiang Li Liang Chun-Lin Wang Hong-Bo Shi Ping Jiang Xi-Yong Liu[4] 

机构地区：[1]Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China [2]Department of Pediatrics, Yinzhou People's Hospital, Ningbo 315400, Zhejiang Province, China [3]The First People's Hospital of Hangzhou, Hangzhou 310003, Zhejiang Province, China [4]Clinical and Molecular Pharmacology, City of Hope National Medical Center, Duarte, CA 91009, United States

出　　处：《World Journal of Gastroenterology》2011年第6期735-742,共8页世界胃肠病学杂志（英文版）

基　　金：Supported by Zhejiang Provincial Natural Science Foundation,No.Y2080047;funds for Zhejiang Major Medical and Health Science and Technology Program; funds from Ministry of Health,No.WKJ2008-2-026;Major Special Zhejiang Provincial Science and Technology Fund,No.2008c03002-1;the National Key Technology R&D Program of China,No.2009BAI80B01

摘　　要：AIM:To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS:We classified 861 obese children (6-16 years old) into three subgroups:group 0 (normal liver in ultrasound and normal transaminases);group 1 (fatty liver in ultrasound and normal transaminases);and group 2 (fatty liver in ultrasound and elevated transaminases).We measured the body mass index,waist and hip circumference,blood pressure,fasting blood glucose,insulin,homeostasis model assessment of insulin resistance (HOMA-IR),whole-body insulin sensitivity index (WBISI),lipid profile and transaminases in all the participants.The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.RESULTS:Among the 861 obese children,587 (68.18%) were classified as having NAFLD,and 221 (25.67%) as having MS.The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587),which was much higher than that in non-NAFLD group (group 0,12.04%) (P < 0.01).There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05).The incidence of NAFLD in MS patients was 84.61% (187/221),which was significantly higher than that of hypertension (57.46%,127/221) and glucose metabolic anomalies (22.62%,50/221),and almost equal to the prevalence of dyslipidemia (89.14%,197/221).Based on the B-ultrasound scales,the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR):2.18,95% confidence interval (95% CI):1.27-3.75],dyslipidemia (OR:7.99,95% CI:4.34-14.73),impaired fasting glucose (OR:3.65,95% CI:1.04-12.85),and whole MS (OR:3.77;95% CI:1.90-7.47,P < 0.01).The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased.CONCLUSION:NAFLD is not only a liver disease,but also an early mediator that reflecAIM：To investigate if non-alcoholic fatty liver disease （NAFLD） is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS：We classified 861 obese children （6-16 years old） into three subgroups：group 0 （normal liver in ultrasound and normal transaminases）;group 1 （fatty liver in ultrasound and normal transaminases）;and group 2 （fatty liver in ultrasound and elevated transaminases）.We measured the body mass index,waist and hip circumference,blood pressure,fasting blood glucose,insulin,homeostasis model assessment of insulin resistance （HOMA-IR）,whole-body insulin sensitivity index （WBISI）,lipid profile and transaminases in all the participants.The risk of developing metabolic syndrome （MS） was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.RESULTS：Among the 861 obese children,587 （68.18%） were classified as having NAFLD,and 221 （25.67%） as having MS.The prevalence of MS in NAFLD children （groups 1 and 2） was 37.64% （221/587）,which was much higher than that in non-NAFLD group （group 0,12.04%） （P 0.01）.There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 （P 0.05）.The incidence of NAFLD in MS patients was 84.61% （187/221）,which was significantly higher than that of hypertension （57.46%,127/221） and glucose metabolic anomalies （22.62%,50/221）,and almost equal to the prevalence of dyslipidemia （89.14%,197/221）.Based on the B-ultrasound scales,the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio （OR）：2.18,95% confidence interval （95% CI）：1.27-3.75],dyslipidemia （OR：7.99,95% CI：4.34-14.73）,impaired fasting glucose （OR：3.65,95% CI：1.04-12.85）,and whole MS （OR：3.77;95% CI：1.90-7.47,P 0.01）.The state of insulin resistance （calculated by HOMA-IR and WBISI） deteriorated as the degr

关 键 词：Childhood obesity Non-alcoholic fatty liver disease Metabolic syndrome Liver B ultrasonography 

分 类 号：S941[农业科学—水产养殖] Q51[农业科学—水产科学]