Objective To study the relationship between non - alcoholic fatty liver disease (NAFLD) and the vascular endothelial dysfunction in children with obesity. Methods A total of 90 obese children and 34 non - obese children as control were enrolled. Their clinical indicators, biochemical indicators, and flow - mediated dilatation ( FMD) of brachial artery were examined. The obese children were classified into two subgroups according to the diagnosis criteria: obesity group without liver disorder (n = 39) and NAFLD group (n =51). The clinical indicators, biochemical indicators, and FMD of brachial artery were compared among the three groups. Results The FMD prevalence in NAFLD group was (7. 9 ±2. 1)% , lower than (10. 6 ±1.7)% in obesity group and (12. 1 ± 2. 1) % in control group, with a significant difference among the 3 groups ( F = 8. 32, P <0. 05 ). The levels of endothelin - 1 ( ET - 1) , high sensitivity C - reactive protein (hs - CRP) , HOMA insulin resistance index (HOMA-IR) and soluble intercellular adhesion molecule (sICAM -1) in NAFLD were all higher than those in obesity and control groups, with a significant difference among the 3 groups (P <0. 05) . The liner stepwise regression analysis showed that the FMD was negatively correlated with hs - CRP, HOMA - IR and NAFLD ( r = - 0. 487 , - 0. 424, - 0. 407 , P < 0. 05 ) . Conclusion NAFLD may be not only an early marker but also an early state of vascular endothelial dysfunction in obese children.%目的 探讨肥胖患儿非酒精性脂肪肝病(NAFLD)与血管内皮功能障碍的关系.方法 90例肥胖患儿以及34例非肥胖儿童(对照组)进行临床、生化指标及肱动脉血流介导的内皮依赖性舒张功能(FMD)各项检查,根据诊断标准将90例肥胖患儿分为NAFLD组51例和单纯肥胖组39例.比较各组儿童临床、生化各项指标及FMD.结果 NAFLD病组患儿FMD为(7.9±2.1)％,低于单纯肥胖组(10.6±1.7)％和对照组(12.1±2.1)％,三组间差异有统计学意义(F=8.32,P＜0.05)；NAFLD组患儿内皮素-1、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)、可溶性细胞间黏附分子-1水平均高于单纯肥胖组和对照组,三组间差异有统计学意义(P＜0.05).经逐步线性回归分析显示,FMD水平和hs-CRP、HOMA-IR、NAFLD呈负相关(r值分别为-0.487、-0.424、-0.407,P＜0.05).结论 肥胖患儿NAFLD的出现不仅是血管内皮功能障碍发生的早期标志,也是血管内皮功能障碍发生的早期状态.
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