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。%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.
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