| Objective:It is a challenge for clinicians to diagnose and treat children with NAFLD because of its insidious onset and the absence of specific therapeutic drugs for NAFLD.This study will summarize the clinical characteristics of non-alcoholic fatty liver disease in overweight and obese children,analyze the risk factors of NAFLD in children,and provide new ideas for the prevention and early treatment of NAFLD in children.Methods:1.A total of 158 overweight and obese children and adolescents aged 8-15 years old who were admitted to the Department of Pediatrics of the First Affiliated Hospital of XX Medical University from September 2020 to November 2022 were collected.After screening the subjects meeting the inclusion and exclusion criteria,the height,body weight,waist circumference,hip circumference,Systolic blood pressure(SBP)and Diastolic blood pressure(DBP)of the children were measured.Waist height ratio(WHtR),Body mass index(BMI),Serum uric acid(SUA)and Fasting blood-glucose(FBG),Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),and blood lipids,including Total cholesterol(TC),Triacylglycerol(TG),High density lipoprotein cholesterol(HDL),Low density lipoprotein in(LDL),all subjects underwent liver B-ultrasound examination.2.According to the results of abdominal ultrasound,the patients were divided into:1.Fatty liver group and 2.Independent sample t test,Mann-Whitney U rank sum test,Chi-square test,were used to compare the fatty liver group and the non-fatty liver group.General data,clinical indicators and complications of the two groups were compared,and clinical characteristics were summarized.3.Binary Logistic regression analysis was used to analyze the risk factors of NAFLD in overweight and obese children.The enrolled subjects were divided into hyperuricemia group and non-hyperuricemia group according to their blood uric acid level.To further explore the relationship between blood uric acid and fatty liver.Results:1.A total of 158 overweight and obese children and adolescents were included,including 90 males,accounting for 57%(90/158),with an average age of 11.75±2.07 years.There were 68 females,accounting for 43%(68/158),and the mean age was12.09±1.92 years old.The total incidence of fatty liver was 42.4%(67/158).2.According to the results of abdominal ultrasound,there were 67 patients in the fatty liver group and the non-fatty liver group.In the fatty liver group,there were 46 males [68.7%(46/67)] and 21 females [31.3%(21/67)].There were 91 patients in the non-fatty liver group,including 44 males,accounting for 48.4%(44/91),and 47 females,accounting for 51.6%(47/91).There was statistical significance in gender distribution between the two groups(P < 0.05).The mean age of the fatty liver group was 12.21±1.73 years old,and the median study age was 12.25(11.08,13.50)years old;the mean age of the non-fatty liver group was 11.67±2.17 years old,and the median study age was 12.16(9.91,13.66)years old,and the age distribution was not statistically significant(P > 0.05).3.BMI,SBP,DBP,WHtR,SUA,AST and ALT in fatty liver group were higher than those in non-fatty liver group,and HDL-c was lower than that in non-fatty liver group,the difference was statistically significant(P < 0.05).4.Comparison of complications between fatty liver group and non-fatty liver group4.1 Hyperuricemia: There were 38 cases of hyperuricemia in the fatty liver group,and the detection rate was 56.7%(38/67).There were 36 cases of hyperuricemia in the non-fatty liver group,and the detection rate was 39.6%(36/91).The detection rate of hyperuricemia in the fatty liver group was significantly higher than that in the non-fatty liver group,and the difference was statistically significant(P < 0.05).4.2 Hypertension: 34 patients in the fatty liver group had hypertension,and the detection rate was 50.7%(34/67).There were 26 cases of hypertension in the non-fatty liver group,the detection rate was 28.6%(26/91),and the detection rate of hypertension in the fatty liver group was significantly higher than that in the non-fatty liver group,the difference was statistically significant(P < 0.05).4.3 Abnormal liver enzymes: There were 32 cases with abnormal liver enzymes in the fatty liver group,the detection rate was 47.8%(32/67).There were 14 cases with abnormal liver enzymes in the non-fatty liver group,the detection rate was 15.4%(14/91),and the difference was statistically significant(P < 0.05).4.4 Abnormal blood glucose: There were 17 cases of abnormal blood glucose in the fatty liver group,the detection rate was 25.4%(17/67),and 15 cases in the non-fatty liver group,the detection rate was 16.5%(15/91),the difference was not statistically significant(P > 0.05).4.5 Dyslipidemia: There were 42 cases of dyslipidemia in the fatty liver group,the detection rate was 62.7%(42/67),and 49 cases in the non-fatty liver group,the detection rate was 53.8%(49/91),the difference was not statistically significant(P >0.05).5.In the Logistic regression analysis,gender,hypertension,hyperglycemia,dyslipidemia,abnormal liver enzymes and hyperuricemia were included to construct the logistic regression equation.5.1.Compared with females,male children and adolescents were more likely to have NAFLD,and the difference was statistically significant(OR=2.269,95%CI1.086-4.742,P < 0.05).5.2 Hypertension increased the risk of NAFLD,with statistical significance(OR=2.351,95%CI 1.110-4.981,P < 0.05).5.3 Abnormal liver enzymes increased the risk of NAFLD,and the difference was statistically significant(OR=3.742,95%CI 1.704-8.219,P < 0.05).5.4.Abnormal blood glucose,hyperuricemia and dyslipidemia were not independent risk factors for NAFLD(P > 0.05).6.Hyperuricemia group and non-hyperuricemia group were divided according to the level of uric acid.6.1 There were 74 cases in hyperuricemia group and 84 cases in non-hyperuricemia group;38 cases of fatty liver in hyperuricemia group(51.4%,38/74);There were 29 cases of fatty liver in the non-hyperuricemia group(34.5%,29/84),and the difference was statistically significant(P < 0.05).6.2 There were 28 cases with abnormal liver enzymes in the hyperuricemia group,the detection rate of 37.8%(28/74),and 18 cases with abnormal liver enzymes in the non-hyperuricemia group,the detection rate of 21.4%(18/84),the difference between the two groups was statistically significant(P < 0.05).7.SUA was positively correlated with BMI,WHtR,SBP and DBP,and negatively correlated with HDL,with statistical significance(P < 0.05).Conclusion:1.Overweight and obese children and adolescents are more likely to develop complications such as hypertension and abnormal liver enzymes.Men have a higher risk of NAFLD than women,and hypertension and abnormal liver enzymes are independent influencing factors of NAFLD.2.Hyperuricemia is closely related to fatty liver development in overweight and obese children and adolescents. |
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