■非酒精性脂肪性肝病(NAFLD)定义为肝脏脂肪百分比增加,是儿童最常见的慢性肝病。而不是NAFLD,代谢相关脂肪性肝病(MAFLD),定义为肝脏脂肪增加,存在不良的心脏代谢指标,在儿童中可能有更多的临床相关性。我们评估了患病率,学龄期MAFLD的危险因素和心脏代谢结局。
■这项横断面分析被纳入了一项正在进行的基于人群的前瞻性队列研究,该研究始于2001年,在荷兰。1910年10岁的孩子,我们通过磁共振成像(MRI)测量肝脏脂肪含量,体重指数(BMI),血压,和脂质,胰岛素,和葡萄糖浓度。通过问卷调查获得儿童期生活方式因素。MAFLD定义为≥2%的肝脏脂肪以及过度肥胖(BMI或内脏肥胖),存在代谢风险(血压,甘油三酯和HDL浓度)或糖尿病前期(葡萄糖)。
■在所有孩子中,49.6%肝脏脂肪≥2%,25.2%符合MAFLD标准。只有非欧洲血统与名义显著性MAFLD的几率增加相关(赔率比1.38,95%置信区间1.04,1.82)。与肝脏脂肪<2%的儿童相比,MAFLD患者发生心脏-代谢-危险因素聚集的几率增加(几率7.65,95%置信区间5.04,11.62).
■在这项研究中,没有NAFLD相关的儿童危险因素与儿童MAFLD的几率增加相关,然而研究结果表明,种族可能是,尽管主要由社会经济因素解释。使用MAFLD标准,而不是NAFLD,可能会发现有心脏代谢健康受损风险的儿童。
■伊拉斯谟大学MC,荷兰卫生研究与发展组织,卫生部,福利,体育,和欧洲研究理事会。
UNASSIGNED: Non-Alcoholic Fatty Liver Disease (NAFLD) is defined as increased liver fat percentage, and is the most common chronic liver disease in children. Rather than NAFLD, Metabolic-Associated Fatty Liver Disease (MAFLD), defined as increased liver fat with presence of adverse cardio-metabolic measures, might have more clinical relevance in children. We assessed the prevalence, risk-factors and cardio-metabolic outcomes of MAFLD at school-age.
UNASSIGNED: This cross-sectional analysis was embedded in an ongoing population-based prospective cohort study started in 2001, in the Netherlands. In 1910 children of 10 years, we measured liver fat fraction by magnetic resonance imaging (MRI), body mass index (BMI), blood pressure, and lipids, insulin, and glucose concentrations. Childhood lifestyle factors were obtained through questionnaires. MAFLD was defined as ≥2% liver fat in addition to excess adiposity (BMI or visceral adiposity), presence of metabolic risk (blood pressure, triglycerides and HDL-concentrations) or prediabetes (glucose).
UNASSIGNED: Of all children, 49.6% had ≥2% liver fat, and 25.2% fulfilled the criteria of MAFLD. Only non-European descent was associated with increased odds of MAFLD at nominal significance (Odds Ratio 1.38, 95% Confidence Interval 1.04, 1.82). Compared to children with <2% liver fat, those with MAFLD had increased odds of cardio-metabolic-risk-factor clustering (Odds Ratio 7.65, 95% Confidence Interval 5.04, 11.62).
UNASSIGNED: In this study, no NAFLD-associated childhood risk factors were associated with increased odds of childhood MAFLD, yet the findings suggest that ethnicity could be, despite mostly explained by socio-economic factors. Use of MAFLD criteria, rather than NAFLD, may identify children at risk for impaired cardio-metabolic health.
UNASSIGNED: Erasmus University MC, the Netherlands Organisation for Health Research and Development, the Ministry of Health, Welfare, and Sport, and the European Research Council.