文章摘要
周歆,侯冬青,段佳丽,孙颖,程红,赵小元,刘军廷,杨平,单馨影,米杰.北京市3 87名肥胖中学生非酒精性脂肪肝等代谢异常罹患状况调查[J].中华流行病学杂志,2013,34(5):446-450
北京市3 87名肥胖中学生非酒精性脂肪肝等代谢异常罹患状况调查
Prevalence of nonalcoholic fatty liver disease and metabolic abnormalities in 387 obese children and adolescents in Beijing, China
收稿日期:2013-01-23  出版日期:2014-09-17
DOI:10.3760/cma.j.issn.0254-6450.2014.02.008
中文关键词: 肥胖;非酒精性脂肪肝
英文关键词: Obesity;Nonalcoholic fatty liver disease
基金项目:北京市科技计划重大项目(D111100000611002,D111100000611003)
作者单位E-mail
周歆 首都儿科研究所流行病学研究室 北京 100020 Email:lwxu2006@163.com 
侯冬青 首都儿科研究所流行病学研究室 北京 100020  
段佳丽 北京市疾病预防控制中心  
孙颖 北京市疾病预防控制中心  
程红 首都儿科研究所流行病学研究室 北京 100020  
赵小元 首都儿科研究所流行病学研究室 北京 100020  
刘军廷 首都儿科研究所流行病学研究室 北京 100020  
杨平 首都儿科研究所流行病学研究室 北京 100020  
单馨影 首都儿科研究所流行病学研究室 北京 100020  
米杰 首都儿科研究所流行病学研究室 北京 100020  
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中文摘要:
      目的 了解北京市城区中学生常规体检筛查肥胖人群中非酒精性脂肪肝(NAFLD)等代谢异常的罹患状况。方法 采用现况调查方法,对北京市西城、海淀区8所中学常规体检筛查出387名12~17岁肥胖学生进行临床健康风险评估,内容包括问卷调查、体格测量、检查黑棘皮症和腹部肝脏超声,以及空腹血糖、血脂(TC、TG、HDL—C和LDL—C)、肝功能血生化指标检测。采用2010年中华医学会肝脏病学分会脂肪肝和酒精性肝病学组推荐的NAFLD诊断标准。用SPSS16.0软件进行统计分析,利用t检验、x2检验、协方差分析及多因素logistic回归分析。结果 387名肥胖中学生的NAFLD检出率为45.0%;糖尿病和空腹血糖受损(IFG)患病率为o.8%和49.1%;随着肥胖程度增加,NAFLD患病率、黑棘皮症检出率、血脂紊乱和肝功能损害程度呈上升趋势。肥胖合并NAFLD中高TC、高LDL.C、低HDL.C、高TG、IFG、肝功能异常和黑棘皮症检出率分别为6.3%、4.0%、37.9%、22.8%、46.0%、17.8%和28.5%,NAFLD组高TG、肝功能异常、黑棘皮症的患病率高于非NAFLD组,差异有统计学意义(P<0.001)。多因素分析显示,肥胖学生BMI每增加1 kg/m2,发生NAFLD的风险增加40%;有黑棘皮症的肥胖学生发生NAFLD风险是无黑棘皮症的2.74倍(95%CI:1.36~5.52),高TG可增加肥胖学生罹患NAFLD的风险(OR=2.75,95%CI:1.48。5.11)。结论 以学校常规体检来源的肥胖学生中NAFLD检出率较高,同时伴有血脂、血糖等代谢异常。高BMI、高TG和黑棘皮症独立作用于NAFLD。
英文摘要:
      Objective To determine the prevalence of nonalcoholic fatty liver disease(NAFLD) and metabolic abnormalities in obese children and adolescents in Beijing. Methods This study involved 387 obese children and adolescents, aged 12 to 17 years in Beijing. Data on anthropometric measurements was collected, including weight, height and age. All subjects underwent a clinic examination containing fasting blood and liver ultrasonography. Nonalcoholic fatty liver disease was diagnosed using diagnostic criteria for nonalcoholic fatty liver disease which was recommended by the Fatty liver and Alcoholic Liver Disease Study Group of Liver Disease Association in China. Results 174 out of the 387 children were diagnosed as having NAFLD. The overall prevalence of NAFLD was 45.0% in this study population. The prevalence rates of NAFLD did not show significant difference between girls and boys. The prevalence rates of diabetes mellitus and IFG were 0.8% and 49.1% respectively. The prevalence rates of HTG,HTC,HLDL-C, LHDL-C, IFG,elevated ALT (or AST) and acanthosis nigricans were 6.3%,4.0%,37.9%,22.8%,46.0%,17.8% and 28.5% in students combined with obesity and NAFLD, respectively. In the NAFLD subgroup, higher prevalence of high TG, acanthosis nigricans, abnormal ALT or AST were seen. With the increasing of obesity, the level of LDL-C, TG, liver function disturbance and prevalence of NAFLD and acanthosis nigricans were aggravated. Under binary logistic regression analysis, results showed that high BMI,acanthosis nigricans and TG were significantly correlated with NAFLD in obese children and adolescent population. Conclusion NAFLD was common in obese children, and the prevalence of NAFLD in obese children was 45.0%.Higher BMI, acanthosis nigricans and abnormal TG were independent risk factors for NAFLD in obese children. Obese children who had been exposed to high risk factors should take the ultrasonograpy.
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