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目的探讨肥胖儿童非酒精性脂肪肝病(NAFLD)的发生与糖、脂代谢异常的关系。方法回顾分析2007~2010年间,浙江舟山医院收治的60例单纯性肥胖患儿的临床及实验室资料,根据是否伴有非酒精性脂肪肝病(NAFLD)分为脂肪肝组和不伴脂肪肝组,分析体质指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMAIR)、血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)。结果 60例单纯肥胖儿童中,脂肪肝组33例,占55%,不伴脂肪肝组27例,占45%。脂肪肝组TG、TC、LDL-C异常的检出率明显高于不伴脂肪肝组(P<0.05),FPG及HDL-C异常检出率差异无统计学意义;脂肪肝组BMI、FINS、HOMA-IR、TG、TC、LDLC均明显高于不伴脂肪肝组(P<0.05),FPG及HDL-C差异无统计学意义。结论伴NAFLD肥胖儿童的糖、脂代谢紊乱程度较不伴NAFLD的肥胖儿童更加严重,说明胰岛素抵抗及脂质代谢紊乱在NAFLD的发生发展中具有重要作用。
Objective To investigate the relationship between the occurrence of non-alcoholic fatty liver disease (NAFLD) and abnormal glucose and lipid metabolism in obese children. Methods The clinical and laboratory data of 60 simple obese children admitted to Zhoushan Hospital of Zhejiang Province from 2007 to 2010 were retrospectively analyzed. According to their association with non-alcoholic fatty liver disease (NAFLD), they were divided into fatty liver group and non-fatty liver group (BMI), fasting blood glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMAIR), serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol ) And high-density lipoprotein cholesterol (HDL-C). Results Among the 60 simple obesity children, 33 cases were fatty liver, accounting for 55%, while 27 cases were not fatty liver, accounting for 45%. The detection rates of abnormal TG, TC and LDL-C in fatty liver group were significantly higher than those without fatty liver group (P <0.05), and there was no significant difference in the detection rate of abnormalities of FPG and HDL-C. Fatty liver group BMI, FINS , HOMA-IR, TG, TC, LDLC were significantly higher than those without fatty liver (P <0.05), FPG and HDL-C was no significant difference. Conclusions Children with NAFLD have more severe disorder of glucose and lipid metabolism than obese children without NAFLD, indicating that insulin resistance and dyslipidemia play an important role in the development of NAFLD.