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肥胖儿童黑棘皮伴非酒精性脂肪性肝病的临床探析

金亚男   

  1. 天津医科大学总医院
  • 收稿日期:2011-06-14 修回日期:2011-11-08 出版日期:2012-02-15 发布日期:2012-02-15
  • 通讯作者: 金亚男

  • Received:2011-06-14 Revised:2011-11-08 Published:2012-02-15 Online:2012-02-15

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摘要： 摘要 目的：探讨黑棘皮（AN）结合非酒精性脂肪性肝病（NAFLD）的检测对于早期发现肥胖儿童代谢紊乱的意义。方法：132例肥胖儿童根据AN及NAFLD的出现情况分为AN伴NAFLD（A组），AN组（B组）及NAFLD组（C组），无AN无NAFLD组（D组），比较4组间体质指数（BMI）、腰围（WC）、空腹血糖（FPG）、三酰甘油（TG）、高密度脂蛋白（HDL）、收缩压（SBP）、舒张压（DBP）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）及4组间代谢综合征（MS）检出率。结果：⑴A组BMI、WC、FINS、HOMA-IR高于B、C、D组，HDL低于D组，DBP 高于C、D，FPG、TG高于B、D组（P＜0.05或P＜0.01）⑵B组DBP高于D组，C组FPG、TG高于D组，B、C组WC、FINS、HOMA-IR高于D组（均P＜0.01）⑶A、B、C、D组检出MS分别为19例（45.24﹪）、5例（16.13﹪）、5例（16.67﹪）、0例(0％)，差异具有统计学意义（?2=22.539，P＜0.001）。132例肥胖儿童中AN 73例，NAFLD 72例，检出率分别为55.3﹪和54.5﹪。结论：AN合并NAFLD儿童较其他肥胖儿童代谢紊乱情况严重，临床上应引起高度重视。

关键词: 肥胖症, 黑棘皮症, 非酒精性脂肪性肝病, 代谢综合征X, 儿童

Abstract: Abstract Objective: To explore the significance of acanthosis nigricans (AN )combining non-alcoholic fatty liver disease (NAFLD) in early discovering metabolic disorders in obese children. Methods: According to the presence of AN and/or NAFLD, 132 obese children were divided into four groups: with AN and NAFLD were recruited as group A, with AN but without NAFLD as group B, with NAFLD but without AN as group C, had no AN and NAFLD as group D. Body mass index(BMI), waist circumference(WC), fasting plasma glucose(FPG), triglyceride(TG), high density lipoprotein-cholesterol(HDL), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR) and the prevalence of MS were compared between the four groups. Results: ⑴BMI,WC,FINS,HOMA-IR in group A were significantly higher than in other groups ,HDL were significantly lower than group D, DBP was higher than group C and D, FPG and TG higher than group B and D （P＜0.05 or P＜0.01）⑵group B had higher DBP than group D, group C had higher FPG、TG than group D, WC、FINS、HOMA-IR in group B and group C were higher than group D(P＜0.01) ⑶The prevalence of MS in group A, group B, group C, group D were respectively 45.24％(19/42), 16.13％(5/31), 16.67％(5/30), 0％(0/29), group A had higher prevalence than the other groups(?2=22.539，P＜0.001). In the 132 obesity, 73( 55.3﹪) had AN, 72(54.5﹪) had NAFLD. Conclusion: obese children with AN and NAFLD had more serious metabolic disorder than the other obesity, we should pay more attention to those who have AN and NAFLD.

Key words: obesity, acanthosis nigricans, non-alcoholic fatty liver disease, metabolic syndrome X, children