CAJ | 학술논문

目的：探讨代谢异常在单纯性肥胖儿童脂肪肝发生中的作用。方法2012年7月至2013年7月在武警陕西省总队医院小儿内分泌专科门诊确诊的158例单纯性肥胖儿童，根据研究对象是否合并代谢异常，分为代谢异常组96例及非代谢异常组62例。对所有研究对象测量身高、体重、腰围、臀围及血压。空腹12小时后，进行肝脏B超，并采集空腹血，检测血脂全套、转氨酶、血糖。结果肥胖代谢异常组身体质量指数、腰臀比与非代谢异常组相比，均具有显著差异（ t值分别为6．22和4．14，均P＜0．05）；腰围身高比与非代谢异常组相比，差异无统计学意义（t＝2．00，P＞0．05）。代谢异常组儿童甘油三酯，谷草转氨酶及谷丙转氨酶的水平均显著高于非代谢异常儿童（t值分别为5．42、7．34和9．56，均P＜0．05）。肥胖儿童仅合并1项代谢异常时脂肪肝发病率为44．44％，当合并4项代谢异常时，发病率高达85．71％，不同程度代谢异常组儿童脂肪肝发病率之间比较具有统计学差异（χ2＝14．32，P＜0．05）。结论肥胖儿童体内代谢异常越严重，脂肪肝发病越高，脂肪肝可能是肥胖儿童体内代谢紊乱达到一定程度的结果。
목적：탐토대사이상재단순성비반인동지방간발생중적작용。방법2012년7월지2013년7월재무경합서성총대의원소인내분비전과문진학진적158례단순성비반인동，근거연구대상시부합병대사이상，분위대사이상조96례급비대사이상조62례。대소유연구대상측량신고、체중、요위、둔위급혈압。공복12소시후，진행간장B초，병채집공복혈，검측혈지전투、전안매、혈당。결과비반대사이상조신체질량지수、요둔비여비대사이상조상비，균구유현저차이（ t치분별위6．22화4．14，균P＜0．05）；요위신고비여비대사이상조상비，차이무통계학의의（t＝2．00，P＞0．05）。대사이상조인동감유삼지，곡초전안매급곡병전안매적수평균현저고우비대사이상인동（t치분별위5．42、7．34화9．56，균P＜0．05）。비반인동부합병1항대사이상시지방간발병솔위44．44％，당합병4항대사이상시，발병솔고체85．71％，불동정도대사이상조인동지방간발병솔지간비교구유통계학차이（χ2＝14．32，P＜0．05）。결론비반인동체내대사이상월엄중，지방간발병월고，지방간가능시비반인동체내대사문란체도일정정도적결과。
Objective To investigate the role of metabolic abnormality in simple obese children with fatty liver.Methods From July 2012 to July 2013, 158 cases of simple obese children diagnosed in Armed Police Corps Hospital of Shaanxi Province were divided into metabolic abnormality group ( n =96 ) and non-metabolic abnormality group ( n =62 ) depending on whether subjects suffering from metabolic abnormalities.Height, weight, waist circumference, hip circumference and blood pressure of all subjects were measured.After 12 hours of fasting, B-ultrasonography was performed on liver, and fasting blood was sampled for testing blood lipid, transaminase and blood glucose. Results BMI and waist/hip ratio were significantly different between two groups ( t value was 6.22 and 4.14, respectively, both P<0.05), but there was no significant difference in waist/height ratio between two groups (t=2.00,P>0.05).TG, AST and ALT levels were significantly higher in metabolic abnormality group than in non-metabolic abnormality group ( t value was 5.42, 7.34 and 9.56, respectively, all P<0.05).The incidence of fatty liver in obese children complicated with one abnormal index of metabolism was 44.4%, while it reached 85.7%when there were four abnormal indexes.The incidence was significantly different between groups of children with different degree of metabolic abnormality (χ2 =14.32, P<0.05).Conclusion Obese children with more severely abnormal metabolic disorders have higher incidence of fatty liver.Fatty liver may be the outcomes of obese children when metabolic disorders develop to certain level.