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Title: Insulin resistance, body composition, and fat distribution in obese children with nonalcoholic fatty liver disease.
Author: Yang HR, Chang EJ.
Journal: Asia Pac J Clin Nutr; 2016; 25(1):126-33. PubMed ID: 26965771.
Abstract:
BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the influence of body composition, especially distribution of body fat, and insulin resistance on nonalcoholic fatty liver disease (NAFLD) in obese children. METHODS AND STUDY DESIGN: One hundred obese children (66 boys, 34 girls) with (n=60) and without NAFLD (n=40) were assessed. Anthropometry, laboratory tests, abdominal ultrasonography, and dual energy x-ray absorption metry (DXA) were evaluated in all subjects. RESULTS: Subject age and measurements of liver enzymes, γ- glutamyl transpeptidase (γGT), uric acid, high-density lipoprotein cholesterol, and insulin resistance were significantly different between the non-NAFLD group and NAFLD group. Body fat and trunk fat percentage were significantly different between the two groups (p<0.001 and p=0.003), whereas extremity fat percentage was not (p=0.683). Insulin resistance correlated significantly with body fat and trunk fat percentages, age, liver enzymes, γGT, and uric acid in obese children. Multiple logistic regression analysis indicated that insulin resistance and trunk fat percentage significantly affected the development of NAFLD in obese children. CONCLUSIONS: Body fat, especially abdominal fat, influences the development of insulin resistance and subsequent NAFLD in obese children. Therefore, body composition measurement using DXA, in conjunction with biochemical tests, may be beneficial in evaluating obese children with NAFLD. 背景与目的：该研究目的是评价身体成分，尤其是脂肪分布和胰岛素抗性对非酒精性脂肪性肝病（NAFLD）肥胖儿童的影响。方法与研究设计：对100 例肥胖儿童（男66，女34）进行评估，其中有NAFLD 的60 例，无NAFLD 的40 例。所有研究对象均接受人体测量学、实验室检查、腹部超声和双能X 线吸收法（DXA）的评估。结果：NAFLD 组和非NAFLD 组研究对象年龄、肝酶、γ-谷氨酰转肽酶（γGT）、尿酸、高密度脂蛋白胆固醇和胰岛素抗性之间差异有统计学意义。两组间身体脂肪和躯干脂肪百分比差异有统计学意义（p<0.001 和p=0.003），而肢体脂肪百分比差异无统计学意义（p=0.683）。肥胖儿童胰岛素抗性与身体和躯干脂肪百分比、年龄、肝酶、γGT 及血尿酸之间有显著相关关系。多因素logistic 回归分析显示胰岛素抗性和躯干脂肪百分比对肥胖儿童非酒精性脂肪肝的发展有显著影响。结论：身体脂肪，尤其是腹部脂肪，影响肥胖儿童胰岛素抗性及其随后非酒精性脂肪肝的发展。因此，使用DXA 测量身体成分，结合生化检测，有利于评价非酒精性脂肪肝肥胖儿童。.

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