唐山市7～14岁肥胖儿童非酒精性脂肪肝流行现状及危险因素初步分析

doi:10.11852/zgetbjzz2020-1489

摘要/Abstract

摘要： 目的初步了解唐山市肥胖儿童非酒精性脂肪肝(NAFLD)流行特点及危险因素,为早期干预提供理论依据。方法以2018—2019年唐山市学龄儿童体检筛查出的肥胖儿童为研究对象,依年龄分组描述NAFLD患病率,比较NAFLD组与非NAFLD组代谢综合征(MetS)、体重指数(BMI)、腰围(WC)、腰围身高比(WHtR)、转氨酶、尿酸(UA)、糖脂代谢等指标,分析NAFLD发生的危险因素。结果 1)唐山市肥胖儿童NAFLD患病率为34.62%,不同性别间差异无统计学意义(χ²=0.009,P=1.000),NAFLD患病率随年龄增加而增高(r=0.425,P<0.001);2)7～9岁NAFLD组脂代谢紊乱患病率、10～14岁NAFLD脂代谢紊乱、高血压、MetS患病率高于非NAFLD组,差异均有统计学意义(χ²=6.159、10.994、5.543、4.524,P<0.05);3)多因素Logistic回归分析显示NAFLD的危险因素为年龄增长(OR=3.91)、高尿酸血症(OR=2.09)、BMI增加(OR=1.07)、ALT升高(OR=1.04)(P<0.05)。结论唐山市肥胖儿童总体NAFLD患病率处于较高水平,其患病率随年龄增长而增高;肥胖儿童NAFLD与年龄、高尿酸血症、BMI、ALT水平密切相关。

关键词: 非酒精性脂肪肝, 肥胖, 儿童, 危险因素

Abstract: Objective To investigate the epidemiological characteristics and risk factors of nonalcoholic fatty liver disease (NAFLD) in obesity children in Tangshan,in order to provide reference for the early intervention. Methods Obesity children screened by physical examination of school-age children in Tangshan City from 2018 to 2019 were the study objects. The prevalence of NAFLD was described by age,and indicators were compared between NAFLD group and non-NAFLD group to analyze the risk factors of NAFLD,including metabolic syndrome (MetS),body mass index (BMI),waist circumference(WC),waist-to-height ration(WHtR),transaminase,uric acid(UA),glucose and lipid metabolism index. Results 1) The prevalence of NAFLD in obesity children in Tangshan was 34.62%,and there was no significant difference between boys and girls (χ²=0.009,P=1.000). The prevalence of NAFLD increased with age (r=0.425,P＜0.001). 2) The prevalence rate of lipid metabolism disorder in 7- to 9-year-old children and 10- to 14-year-old children,and the prevalence rate of hypertension,MetS in 10- to 14-year-old children in NAFLD group were significantly higher than those in non-NAFLD group(χ²=6.159,10.994,5.543,4.524,P＜0.05). 3) Multivariate Logistic regression analysis showed that the risk factors of NAFLD included older age,hyperuricemia(HUA),higher BMI,higher ALT(OR=3.91,2.09,1.07,1.04,P<0.05). Conclusions The overall prevalence rate of obese children in Tangshan is at a high level,and the prevalence rate of NAFLD increases with age. The onset of NAFLD in obese children is closely related to older age,HUA,higher BMI and ALT level.

Key words: nonalcoholic fatty liver, obesity, children, risk factor

中图分类号:

陈新春, 寇永妹, 刘晓璐, 李丹, 杨雪冰. 唐山市7～14岁肥胖儿童非酒精性脂肪肝流行现状及危险因素初步分析[J]. 中国儿童保健杂志, 2021, 29(6): 669-673.

CHEN Xin-chun, KOU Yong-mei, LIU Xiao-lu, Li Dan, YANG Xue-bing. Prevalence and risk factors of nonalcoholic fatty liver disease among obesity children aged 7 to 14 years in Tangshan city[J]. Chinese Journal of Child Health Care, 2021, 29(6): 669-673.

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