膳食纤维在肥胖儿童非酒精性脂肪肝中的疗效研究  

Clinical Research of the Therapeutic Effect of Dietary Fiber on Non-Alcoholic Fatty Liver Disease in Obese Children

作　　者：徐清田 XU Qingtian(Department of Clinical Nutrition,Wuxi People's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡市人民医院临床营养科,无锡214023

出　　处：《中国医药指南》2024年第13期15-18,共4页Guide of China Medicine

基　　金：南京医科大学无锡医学中心科研项目(wmcc202322);江苏省无锡市科技发展资金项目(Y20212024)。

摘　　要：目的 探讨膳食纤维在肥胖儿童合并非酒精性脂肪肝(NAFLD)中的临床疗效。方法 选取2019年4月至2023年4月于南京医科大学附属无锡市人民医院及无锡市儿童医院就诊的98例学龄期肥胖合并NAFLD儿童,随机分为研究组(49例)和对照组(49例),两组研究对象均予改变生活方式和中等量有氧运动的基础治疗,同时研究组口服补充膳食纤维粉25 g/d,两组均持续治疗90 d。比较两组治疗前及治疗后的人体成分、肝脏彩超、血脂、空腹血糖、胰岛功能、肝功能指标、炎症因子水平,采用脂肪肝指数(FLI)作疗效评价,比较两组FLI <30的发生率及两组临床疗效,记录治疗期间不良反应。结果 治疗后两组血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转移酶、C反应蛋白、血脂、空腹血糖等水平均较治疗前下降(P <0.05),胰岛素抵抗较前改善(P <0.01),FLI较前有下降,且研究组FLI低于对照组(29.01±2.97 vs.31.43±4.73,P <0.01);治疗后两组内脏脂肪面积、体脂率及腰围均较治疗前下降(P <0.01),复查肝脏彩超提示两组脂肪肝情况均有改善,且研究组改善更明显。治疗后两组患者FLI均<60,研究组FLI <30的发生率高于对照组(77.6%vs.53.1%,P=0.019)。治疗期间,两组患者均无不良反应。结论 膳食纤维具有良好的减脂、减重效果,能改善患儿胰岛素抵抗及肝功能指标,显著改善脂肪肝情况,是防治肥胖儿童NAFLD的一种安全有效方法。Objective To explore the clinical efficacy of dietary fiber in obese children with combined non-alcoholic fatty liver disease(NAFLD).Methods A total of 98 cases of school-age obese children with combined NAFLD attending Wuxi People's Hospital and Wuxi Children's Hospital affiliated to Nanjing Medical University from April 2019 to April 2023 were selected and randomly divided into the study group(49 cases) and the control group(49 cases),and the study subjects of both groups were given the basic treatment of lifestyle modification and moderate amount of aerobic exercise,while the study group was given the supplemental dietary fiber powder of 25 g/d orally,and both groups continued treatment for 90 d.The body composition,liver ultrasound,blood lipids,fasting blood glucose,pancreatic islet function,liver function indexes,inflammatory factor levels of the two groups before and 90 d after treatment were detected and compared,and the fatty liver index(FLI) was used for the evaluation of the therapeutic efficacy,comparing the incidence of FLI <30 and the clinical efficacy of the two groups,and recording the adverse reactions during the treatment period.Results After treatment,serum alanine aminotransferase,aspartate aminotransferase,glutamyltransferase,Creactive protein,blood lipids,fasting glucose and other levels in the two groups decreased compared with the pre-treatment level(P<0.05),insulin resistance improved compared with the pre-treatment level(P<0.01),and the FLI decreased compared with the pre-treatment level,and FLI in the study group was lower than that in the control group(29.01±2.97 vs.31.43±4.73,P<0.01);after treatment,visceral fat area,body fat percentage and waist circumference decreased in both groups compared with before treatment(P<0.01),and liver ultrasound suggested that fatty liver was improved in both groups,and the improvement in the study group was more obvious.After treatment,FLI was <60 in both groups,and the incidence of FLI <30 in the study group was higher than that in the control group(

关 键 词：膳食纤维 肥胖儿童 非酒精性脂肪肝 

分 类 号：R575.5[医药卫生—消化系统] R72[医药卫生—内科学]