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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Metabolic Features of Nonalcoholic Fatty Liver (NAFL) in Obese Adolescents: Findings From a Multiethnic Cohort
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Metabolic Features of Nonalcoholic Fatty Liver (NAFL) in Obese Adolescents: Findings From a Multiethnic Cohort

机译：肥胖青少年非酒精性脂肪肝（NAFL）的代谢特征：多民族队列的研究结果

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We conducted a prospective study in a large, multiethnic cohort of obese adolescents to characterize clinical and genetic features associated with pediatric nonalcoholic fatty liver (NAFL), the most common cause of chronic liver disease in youth. A total of 503 obese adolescents were enrolled, including 191 (38.0%) whites, 134 (26.6%) blacks, and 178 (35.4%) Hispanics. Participants underwent abdominal magnetic resonance imaging (MRI) to quantify hepatic fat fraction (HFF), an oral glucose tolerance test (OGTT) to assess glucose tolerance and insulin sensitivity, and the genotyping of three single‐nucleotide polymorphisms (SNPs) associated with nonalcoholic fatty liver disease (NAFLD) (patatin‐like phospholipase domain‐containing protein 3 [ PNPLA3 ] rs738409, glucokinase regulatory protein [ GCKR ] rs1260326, and transmembrane 6 superfamily member 2 [ TM6SF2 ] rs58542926). Assessments were repeated in 133 subjects after a 2‐year follow‐up. Prevalence of nonalcoholic fatty liver (NAFL) was 41.6% (209 patients) and ranged widely among ethnicities, being 42.9% in whites, 15.7% in blacks, and 59.6% in Hispanics ( P 0.0001). Among adolescents with NAFL, blacks showed the highest prevalence of altered glucose homeostasis (66%; P ?=?0.0003). Risk factors for NAFL incidence were white or Hispanic ethnicity ( P ?=?0.021), high fasting C‐peptide levels ( P ?=?0.0006), and weight gain ( P ?=?0.0006), whereas baseline HFF ( P ?=?0.004) and weight loss ( P ?=?0.032) predicted resolution of NAFL at follow‐up. Adding either gene variant to these variables improved significantly the model predictive performance. Conclusion: Black obese adolescents are relatively protected from liver steatosis, but are more susceptible to the deleterious effects of NAFL on glucose metabolism. The combination of ethnicity/race with markers of insulin resistance and genetic factors might help identify obese youth at risk for developing NAFL.
机译：我们在大型多种群的肥胖青少年进行了一项前瞻性研究，以表征与儿科非酒精脂肪肝（NAFL）相关的临床和遗传特征，青年中慢性肝病最常见的原因。共有503名肥胖青少年，包括191（38.0％）白人，134名（26.6％）黑人，178名（35.4％）西班牙裔。参与者接受腹部磁共振成像（MRI）来量化肝脂肪级分（HFF），口服葡萄糖耐量试验（OGTT），以评估葡萄糖耐受性和胰岛素敏感性，以及与非酒精性脂肪相关的三种单核苷酸多态性（SNP）的基因分型肝脏疾病（NAFLD）（含有粉型磷脂酶结构域域蛋白质3 [PNPLA3] RS738409，葡萄糖蛋白酶调节蛋白[GCKR] RS1260326，以及跨膜6超家族成员2 [TM6SF2] RS58542926）。在2年后续后，在133名受试者中重复评估。非酒精性脂肪肝（NAFL）的患病率为41.6％（209名患者），种族广泛，白人的42.9％，黑人15.7％，西班牙语的59.6％（P <0.0001）。在具有Nafl的青少年中，黑人表现出改变葡萄糖稳态的最高流行（66％; P？= 0.0003）。 NAFL发病率的危险因素是白人或西班牙裔或西班牙裔（P？= 0.021），高禁食C-肽水平（P？= 0.0006），重量增益（P？= 0.0006），而基线HFF（P？= 0.004）和体重减轻（P？= 0.032）预测随后的NAFL的分辨率。将这些变量添加到这些变量的基本变体显着提高了模型预测性能。结论：黑肥胖青少年相对保护肝脏脂肪变性，但更容易对NAFL对葡萄糖新陈代谢的有害影响。种族/种族与胰岛素抵抗和遗传因素标记的组合可能有助于识别肥胖的青年，以冒NAFL的风险。

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