中国实用儿科杂志

中国实用儿科杂志 ›› 2023, Vol. 38 ›› Issue (7): 525-529.DOI: 10.19538/j.ek2023070610

• 论著 • 上一篇    下一篇

非酒精性脂肪性肝病肥胖儿童人体成分及其影响因素分析

  

  1. 国家儿童医学中心（北京）  首都医科大学附属北京儿童医院临床营养科，北京 100045
  • 出版日期:2023-07-06 发布日期:2023-08-29
  • 通讯作者: 闫洁，电子信箱：yanjie804@sina.com

Analysis of body composition and risk factors of non-alcoholic fatty liver disease in obese children

  1. Department of Nutrition，Beijing Children’s Hospital of Capital Medical University，Children's National Medical Center，Beijing 100045，China
  • Online:2023-07-06 Published:2023-08-29

摘要： 目的　分析肥胖儿童非酒精性脂肪性肝病（NAFLD）人体成分及其影响因素，为临床防治提供依据。方法　纳入2019年1月至2021年7月首都医科大学附属北京儿童医院就诊236例肥胖儿童，依据诊断标准分组：NAFLD组135例、非NAFLD组101例。采用人体成分分析仪检测人体成分，并收集患儿一般资料，完善血生化、糖化血红蛋白、空腹胰岛素、空腹C肽、腹部彩超等检查，分析各指标特点。结果　236例肥胖患儿中男148例、女88例，年龄4～17岁，平均年龄为（9.78±2.39）岁。236例中体脂肪升高232例、体脂百分比升高235例，蛋白质升高22例、无机盐升高23例、肌肉量升高32例。两组指标体重指数、体脂肪、蛋白质、无机盐、体脂百分比、内脏脂肪面积、无脂肪质量指数（SMMI）、肌肉质量指数（FFMI）、基础代谢量比较，NAFLD组高于非NAFLD组，差异有统计学意义（P<O.05）。两组甘油三酯、低密度脂蛋白、丙氨酸转氨酶、天冬氨酸转移酶、谷氨酰胺转移酶、尿酸、空腹C肽、空腹胰岛素比较，NAFLD组高于非NAFLD组，差异有统计学意义（P<O.05）。Logistic多因素分析显示性别、丙氨酸氨基转氨酶、内脏脂肪面积、体脂肪、体脂百分比是肥胖儿童伴发NAFLD的独立危险因素。结论　肥胖儿童中NAFLD有较高的发生率，人体成分分析可以为肥胖伴NAFLD儿童提供更全面的诊疗评估。丙氨酸氨基转氨酶、内脏脂肪面积、体脂肪、体脂百分比升高以及男性为肥胖儿童发生NAFLD的高危因素，临床应对其提高警惕。

关键词: 儿童, 非酒精性脂肪性肝病, 身体成分, 危险因素, 肥胖

Abstract: Objective　To analyze the body composition and risk factors of non-alcoholic fatty liver disease in obese children and to provide basis for its clinical prevention and treatment. Methods　A total of 236 obese children from the Capital University of Medical Sciences Affiliated Beijing Children's Hospital were included in the study. They were dividid into two groups according to diagnosis criteria：135 in NAFLD group and 101 in non-NAFLD group. The body composition of the patients was measured by the body composition analyzer， and the general data of the patients were collected. Blood biochemistry， glycated hemoglobin， fasting insulin， fasting c-peptide and abdominal color ultrasound were examined. The features of the indexes were analyzed. Results　There were 148 males and 88 females， who aged 4-17 years， with an average age of （9.78 ± 2.39） years. In the 236 children， 232 had elevated fatlevel and 235 had higher percentage of body fat；protein was wigher in 22，inorganic salt was higher in 23 and the amount of muscle was higher in 32 children. The BMI，body fat，protein，inorganic salt，body fat percentage，visceral fat area，SMMI，FFMI，and basic energy metabolism were significantly higher in the NAFLD group than in the non-NAFLD group（P<0.05）. Serology analysis showed that NAFLD group had significantly higher levels of triglyceride，low density lipoprotein，alanine transaminase，aspartate transaminase，l-glutamine，uric acid，fasting C peptide and fasting insulin than non-NAFLD group. Logistic multivariate analysis showed that gender, ALT, visceral fat area, body fat, and Body fat percentage were independent risk factors for NAFLD in obese children. Conclusion　The incidence of NAFLD is high in obese children. Body composition analysis can provide a more comprehensive diagnosis and treatment assessment for obese children with NAFLD.The increase of Alt, splanchnic fat area, body fat, Body fat percentage and male are the high risk factors of NAFLD in obese children. clinical should be alert to them.

Key words: child, NAFLD, body composition, risk factors, obese