小学生非酒精性脂肪性肝病与慢性代谢性疾病的关系

摘要

Objectives To investigate the prevalence of non-alcoholic fatty liver (NAFLD) disease and its correlation with chronic metabolic diseases in two primary school students in Shanghai. Methods One thousand ifve hundred and thirty-two 7-11 year-old students from two primary schools were enrolled in Septamber-October 2011. The anthropometric indices, blood pressure, screening for pseudoacanthosis nigricans and liver ultrasonography of all subjects were recorded. Results The overall prevalence of NAFLD, obesity, abdominal obesity, pseudoacanthosis nigricans, high systolic blood pressure and high diastolic blood pressure was 6.5%, 26.7%, 16.3%, 5.1%, 1.7%and 1.9%, respectively. The prevalence of NAFLD and abdomi-nal obesity in students of central urban area was signiifcantly higher than that in suburban area (P<0.01). The binary regression analysis revealed a signiifcant association between NAFLD in students with sex, age, obesity, abdominal obesity, pseudoacan-thosis nigricans and high systolic blood pressure (P<0.05). Conclusions NAFLD has close correlation with chronic metabolic disease in children. It is time to adopt prevention, detection and treatment in NAFLD children with symptoms of chronic meta-bolic diseases.%目的探讨上海地区在校小学生非酒精性脂肪性肝病（NAFLD）流行现况及其与相关慢性代谢性疾病的关系。方法2011年9-10月调查上海市2所小学共1532名在校学生，测量体格指标、血压，筛查假性黑棘皮症，及行肝脏超声检查。结果 NAFLD、肥胖、中心型肥胖、假性黑棘皮症、高收缩压和舒张压的检出率分别为6.5%（99/1532）、26.7%（409/1532）、16.3%（249/1532）、5.1%（78/1532）、1.7%（26/1532）、1.9%（29/1532）。中心城区小学中心型肥胖、NALFD检出率显著高于近郊城区小学，差异有统计学意义（P<0.01）。多因素Logistic回归分析显示，男性、年龄、肥胖、中心型肥胖、假性黑棘皮病、高舒张压是影响儿童NAFLD的主要危险因素。结论儿童NAFLD与慢性代谢性疾病关系密切。NAFLD儿童已出现慢性代谢性疾病异常特征，应引起足够重视、加强干预和随访。