Risk factors of fatty liver in obese children
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摘要:
目的 分析肥胖儿童并发脂肪肝的危险因素。 方法 搜集2014年1月~2016年12月在某三甲医院住院的肥胖儿童，并通过肝脏B超的检测，将肥胖儿童分成单纯肥胖组和肥胖合并脂肪肝组。计算体质量指数和体内平衡模型胰岛素抵抗指数（HOMA-IR）。 结果 共186例患者纳入研究，单纯肥胖组和肥胖合并脂肪肝组均为93例。肥胖合并脂肪肝组的男性比例、年龄、腰围、体质量指数水平比单纯肥胖组高，差异有统计学意义（P<0.05）。年龄、HOMA-IR和尿酸是肥胖儿童发生脂肪肝的危险因素（OR>1，P<0.05）。 结论 男性、大龄、HOMA-IR和尿酸高的肥胖儿童更容易出现脂肪肝。 Abstract:Objective To investigate metabolic differences between simple obese children and those comorbid with fatty liver disease. Methods Obese children hospitalized in our center during 2014-2016 were included and divided into simple obese group and obese with fatty liver group by ultrasound-based diagnosis of fatty liver. Epidemiology data and serum biochemical studies were recorded. Body Mass Index (BMI) and homeostasis model insulin resistance index (HOMA-IR) were calculated. Results A total of 186 obese children were enrolled in this study, including 93 cases of obese children and 93 cases obese patients with fatty liver.The proportion of men and the figure of age, waist circumstance (WC) and BMI were significantly higher in the group of obese patients with fatty liver (P<0.05). Age and UA were found to be risk factors for fatty liver disease (OR>1,P<0.05). Conclusion Male, older children or children with higher uric acid are more susceptible to fatty liver among obese children. -
Key words:
- children /
- obesity /
- fatty liver disease /
- risk factors
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表 1 两组患者的一般情况和代谢特点比较（n=93）
因素 单纯肥胖组 肥胖合并脂肪肝组 P 性别[男，n（%）] 54（58%） 73（78%） 0.003 年龄（岁） 9（1, 16） 12（7, 16） 0.000 BMI（kg/m2） 25.5±3.4 28.1±3.7 0.000 腰围（cm） 83.5±11.5 92.0±9.9 0.000 BMI: 体质量指数. 
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表 2 肥胖儿童脂肪肝危险因素分析
因素 B S.E. Wald P OR 95%CI 性别 0.525 0.391 1.803 0.179 1.691 0.786~3.640 年龄 0.201 0.091 4.818 0.028 1.222 1.022~1.462 BMI 0.065 0.087 0.568 0.451 1.067 0.901~1.265 腰围 0.000 0.031 0.000 0.992 1.000 0.940~1.063 HOMA-IR 0.105 0.054 3.811 0.050 1.111 1.000~1.234 甘油三酯 0.165 0.385 0.183 0.668 1.179 0.554~2.510 总胆固醇 -0.468 0.546 0.735 0.391 0.626 0.215~1.825 HDL-C 1.191 0.793 2.258 0.133 3.290 0.696~15.554 LDL-C 0.369 0.595 0.385 0.535 1.446 0.451~4.640 尿酸 0.004 0.002 4.131 0.042 1.004 1.000~1.008 BMI: 体质量指数; HOMA-IR: 体内平衡模型胰岛素抵抗指数; HDL-C: 高密度脂蛋白胆固醇; LDL-C: 低密度脂蛋白胆固醇.
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