肥胖儿童非酒精性脂肪性肝病血清25(OH)D水平变化及临床意义

摘要/Abstract

摘要： 目的探讨肥胖儿童非酒精性脂肪性肝病(NAFLD)血清25-羟基维生素D[25(OH)D]水平变化及其临床意义。方法选取2021年4月—2023年4月德阳市人民医院收治的120例肥胖儿童的临床资料进行相关性分析,根据患儿有无NAFLD分为肥胖伴NAFLD组和肥胖组,分别为54例、66例。比较两组患儿的临床资料,采取多因素logistic回归性分析肥胖儿童NAFLD的危险因素。结果肥胖伴NAFLD组男童34例(62.96%),肥胖组男童28例(42.42%)(χ²=5.017,P=0.025);肥胖伴NAFLD组年龄(12.23±3.04)岁,肥胖组年龄(10.48±2.62)岁(t=3.386,P=0.001);肥胖伴NAFLD组BMI(30.07±5.11)kg/m²,肥胖组BMI(25.06±2.55)kg/m²(t=6.978,P=0.000);肥胖伴NAFLD组TG(1.29±0.32)mmol/L,肥胖组TG(0.88±0.24)mmol/L(t=8.015,P=0.000);肥胖伴NAFLD组LDL-C(2.54±0.74)mmol/L,肥胖组LDL-C(2.29±0.52)mmol/L(t=2.168,P=0.032);肥胖伴NAFLD组FINS(12.68±3.84)mmol/L,肥胖组FINS(9.67±3.11)mmol/L(t=4.745,P=0.000);肥胖伴NAFLD组HOMA-IR(2.05±0.34),肥胖组HOMA-IR(1.78±0.38)(t=4.058,P=0.000);肥胖伴NAFLD组ALT(52.74±14.81)U/L,肥胖组ALT(24.16±7.22)U/L(t=13.808,P=0.000);肥胖伴NAFLD组AST(36.02±10.14)U/L,肥胖组AST(22.44±6.43)U/L(t=8.912,P=0.000);肥胖伴NAFLD组25(OH)D(21.03±5.14)ng/mL,肥胖组25(OH)D(25.08±6.86)ng/mL(t=3.590,P=0.001)(P<0.05)。经logistic分析,BMI、HOMA-IR为肥胖儿童NAFLD的独立危险因素,25(OH)D为肥胖儿童NAFLD的保护因素(P<0.05)。结论肥胖伴NAFLD儿童血清25(OH)D水平明显降低,监测其变化可指导临床方案的制定。

关键词: 肥胖儿童, 非酒精性脂肪性肝病, 25-羟基维生素D

Abstract: Objective To investigate the changes of serum 25-hydroxyvitamin D[25(OH)D] levels and its clinical significance in obese children with nonalcoholic fatty liver disease (NAFLD). Methods The clinical data of 120 obese children admitted to our hospital from April 2021 to April 2023 were selected for a correlation analysis. According to whether the children had NAFLD or not, they were divided into an obesity group with NAFLD and an obesity group without NAFLD, with 54 cases and 66 cases in each group, respectively. The clinical data of the two groups were compared. Multivariate logistic regression was used to analyze the risk factors of NAFLD in obese children. Results There were 34 (62.96%) boys in the obese NAFLD group and 28 (42.42%) boys in the obese group (χ²=5.017, P=0.025). The average age of the obese MAFLD group was (12.23±3.04) years, and that of the obese group was (10.48±2.62) years (t=3.386, P=0.001). Body mass index (BMI) in the obese NAFLD group was (30.07±5.11) kg/m², and that of the obese group was (25.06±2.55) kg/m² (t=6.978, P=0.000). Triglyceride (TG) in the obese NAFLD group was (1.29±0.32) mmol/L, and that of the obese group was (0.88±0.24) mmol/L (t=8.015, P=0.000). Low-density lipoprotein cholesterol (LDL-C) in the obese NAFLD group was (2.54±0.74) mmol/L, and that of the obese group was (2.29±0.52) mmol/L, (t=2.168, P=0.032). Fasting insulin (FINS) in the obese group was (12.68±3.84) mmol/L and that of the obese group was (9.67±3.11) mmol/L (t=4.745, P=0.000). Homeostasis model assessment-insulin resistance (HOMA-IR) of the obese NAFLD group was (2.05±0.34) and that of the obese group was (1.78±0.38) (t=4.058, P=0.000). Alanine transaminase (ALT) in the obese NAFLD group was (52.74±14.81) U/L and that of the obese group was (24.16±7.22) U/L (t=13.808, P=0.000). Aspartate transaminase (AST) in the obese NAFLD group was (36.02±10.14) U/L and that in he obese group was (22.44±6.43) U/L (t=8.912, P=0.000). Serum 25-hydroxyvitamin D [25(OH)D] in the obese NAFLD group was (21.03±5.14) ng/mL, and that of the obesity group was (25.08±6.86) ng/mL (t=3.590, P=0.001). Logistic analysis showed that BMI and HOMA-IR were independent risk factors, and 25(OH)D was a protective factor for NAFLD in obese children (P<0.05). Conclusion Serum 25(OH)D level in obese children with NAFLD are significantly decreased. The. monitoring of serum 25(OH)D level may provide guidance for formulating clinical protocols.

Key words: Obese children, Nonalcoholic fatty liver disease, 25-hydroxyvitamin D

李洪林, 邓全敏. 肥胖儿童非酒精性脂肪性肝病血清25(OH)D水平变化及临床意义[J]. 肝脏, 2023, 28(7): 810-813.

LI Hong-lin, DENG Quan-min. The clinical significance of the alteration of serum 25(OH)D levels in obese children with nonalcoholic fatty liver disease[J]. Chinese Hepatolgy, 2023, 28(7): 810-813.

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