Background
Methods
Subjects and inclusion criteria
Anthropometric measurements
Blood biochemical examination
Abdominal ultrasound examination
Definitions for metabolic syndrome and cardiovascular risk factors
Statistical analysis
Results
Demographic and clinical characteristics of participants
Groups | SOB | NAFLD | F/Z/χ2 | p-value | |
---|---|---|---|---|---|
SS | NASH | ||||
N (M/F) | 148 (96/52) | 235 (161/74) | 45 (42/3) | 13.73 | 0.001 |
Age (y) | 10.19 ± 1.76 | 10.46 ± 1.71 | 10.65 ± 1.76 | 1.71 | 0.181 |
Tanner Stage, n (%) | 4.38 | 0.357 | |||
1 | 86 (58.90%) | 127 (55.70%) | 23 (51.10%) | ||
2–3 | 53 (36.30%) | 88 (38.60%) | 22 (48.90%) | ||
4–5 | 7 (4.80%) | 13 (5.70%) | 0 (0.00%) | ||
BMI (kg/m2) | 25.16 (2.79)ab | 28.14 (3.93)a | 29.45 (4.42) | 39.75 | 0.001 |
BMI-SDS | 2.72 (0.76)ab | 3.20 (0.89)a | 3.60 (0.98) | 21.83 | 0.001 |
Body fat (kg) | 20.50 (5.87)ab | 26.67 (8.38)a | 29.33 (10.29) | 35.91 | 0.001 |
Percentage of body fat (%) | 37.12 ± 5.38ab | 40.40 ± 6.10 | 41.06 ± 6.27 | 16.15 | 0.001 |
Skeletal muscle (kg) | 18.24 ± 4.53ab | 20.58 ± 5.35 | 22.25 ± 6.99 | 13.03 | 0.001 |
Percentage of skeletal muscle (%) | 33.01 ± 3.14ab | 31.69 ± 3.43a | 30.17 ± 4.78 | 11.64 | 0.001 |
Waist circumference (cm) | 83.62 ± 8.48ab | 92.50 ± 10.45a | 96.14 ± 10.25 | 45.26 | 0.001 |
WHtR (%) | 0.57 ± 0.05ab | 0.61 ± 0.05 | 0.63 ± 0.04 | 35.42 | 0.001 |
SBP (mmHg) | 111 ± 15ab | 116 ± 16a | 123 ± 16 | 11.86 | 0.001 |
DBP (mmHg) | 65 ± 10ab | 69 ± 10 | 71 ± 10 | 8.01 | 0.001 |
Comparison of biochemical parameters in children with obesity with or without NAFLD
Groups | SOB | NAFLD | F/Z | p-value | |
---|---|---|---|---|---|
SS | NASH | ||||
ALT (U/L) | 17 (9)ab | 26 (21)a | 106 (41) | 161.92 | 0.001 |
AST (U/L) | 22 (8)ab | 26 (14)a | 62 (26) | 112.41 | 0.001 |
Uric acid (μmol/L) | 352 (96)ab | 406 (124)a | 455 (141) | 49.96 | 0.001 |
Triglycerides (mmol/L) | 1.05 (0.62)ab | 1.37 (0.91) | 1.31 (0.90) | 16.83 | 0.001 |
Cholesterol (mmol/L) | 4.25 ± 0.99a | 4.33 ± 0.89 | 4.59 ± 0.88 | 2.29 | 0.103 |
HDL (mmol/L) | 1.27 (0.37)b | 1.17 (0.36) | 1.18 (0.30) | 18.23 | 0.001 |
Fasting glucose (mmol/L) | 4.73 ± 0.44b | 4.61 ± 0.48 | 4.61 ± 0.59 | 3.08 | 0.047 |
Fasting insulin (mU/L) | 12.71 (12.08)a | 15.01 (14.39)a | 21.30 (7.60) | 12.39 | 0.002 |
HOMA-IR | 2.77 (2.53)a | 3.06 (3.00)a | 4.2 (4.61) | 10.39 | 0.006 |
Prevalence of metabolic syndrome and cardiovascular risk factors in NAFLD compared with children without NAFLD
Factors | SOB (N = 148) | NAFLD | χ2 | p-value | |
---|---|---|---|---|---|
SS (N = 235) | NASH (N = 45) | ||||
Abdominal obesity | |||||
Waist circumference (cm) ≥ p90, % | 144 (97.3%) | 234 (99.6%) | 45 (100.0%) | 4.67 | 0.097 |
Elevated blood pressure | |||||
SBP or DBP ≥ p90, % | 62 (41.9%)a | 146 (62.1%) | 30 (66.7%) | 17.56 | 0.001 |
Dyslipidemia | |||||
Triglycerides (mmol/L) ≥ 1.47 mmol/L, % | 57 (38.5%)ab | 133 (56.6%) | 27 (60.%) | 13.44 | 0.001 |
HDL (mmol/L) < 1.03 mmol/L, % | 15 (10.1%)b | 65 (27.7%) | 8 (17.8%) | 17.63 | 0.001 |
Impaired fasting glucose | |||||
Fasting Glucose ≥5.6 mmol/L, % | 2 (1.4%) | 6 (2.6%) | 2 (4.4%) | 1.55 | 0.460 |
Insulin resistance | |||||
HOMA-IR (≥3.16), % | 57 (38.5%)ab | 110 (46.8%)a | 31 (68.9%) | 12.87 | 0.002 |
Hyperuricemia | |||||
Uric Acid (umol/L) ≥ 357umol/L, % | 68 (45.9%)ab | 161 (68.5%)a | 39 (86.7%) | 32.63 | 0.001 |
Metabolic syndrome, % | 29 (19.6%)ab | 117 (49.8%) | 24 (53.3%) | 38.47 | 0.001 |
Correlates of NASH with obesity or metabolic risks
Adjusted OR (95% CI) | p-value | |
---|---|---|
BMI-SDS category | ||
2 ≤ BMI-SDS < 3r | 1 | |
BMI-SDS ≥ 3 | 2.56 (1.06–6.17) | 0.037 |
Gender | ||
Femalesr | 1 | |
Males | 4.94 (1.41–17.35) | 0.013 |
Hyperuricemia | ||
Nor | 1 | |
Yes | 2.98 (1.14–7.76) | 0.025 |
Insulin resistance | ||
Nor | 1 | |
Yes | 2.71 (1.29–5.69) | 0.009 |