肥胖儿童非酒精性脂肪肝病早期肾脏损伤状况研究

发布时间：2018-11-01 15:21

【摘要】：目的：探讨肥胖非酒精性脂肪肝病(Non-alcoholic fatty liver disease, NAFLD)患儿的早期肾脏损伤状况。方法：386例肥胖儿童,根据诊断标准分成NAFLD组及单纯性肥胖组(对照组),进行临床、生化指标及尿微量白蛋白等各项检查,并进行分层检验,比较各组儿童临床、生化各项指标及尿微量白蛋白；对其中10岁以上234例肥胖儿童,根据诊断标准细分为NAFLD合并代谢综合征(Metabolic syndrome, MS)组(NAFLD+MS)、NAFLD组及单纯肥胖组,进行临床、生化指标及尿微量白蛋白等各项检查,比较各组儿童临床、生化各项指标及尿微量白蛋白并检测其相关性。结果：总体NAFLD患儿、10岁以上的NAFLD+MS患儿,NAFLD患儿,其尿微量白蛋白显著高于单纯肥胖儿童,提示NAFLD及NAFLD合并MS患儿存在着早期的肾功能损害,并且随年龄增长,其早期肾脏损害更为明显；并且尿微量白蛋白同收缩压、甘油三脂、餐后2h血糖成显著正相关性(P0.05),提示高血压、糖脂代谢异常在患儿早期肾功能损害及慢性肾病的发病过程中发挥了一定作用。结论：肥胖儿童NAFLD的出现不仅是发生肾脏损伤的早期标志,而且也可能是慢性肾病发生的早期状态。其发生发展的过程同高血压、糖脂代谢异常显著相关,因此,NAFLD、MS的早期诊断和治疗对于预防早期肾脏损伤及慢性肾病发生发展是非常重要的。
[Abstract]:Objective: to investigate the early renal injury in obese children with non-alcoholic fatty liver disease (Non-alcoholic fatty liver disease, NAFLD). Methods: 386 obese children were divided into NAFLD group and simple obesity group (control group) according to the diagnostic criteria. Biochemical indexes and urinary microalbumin; According to the diagnostic criteria, 234 obese children over 10 years old were subdivided into (NAFLD MS), NAFLD group and simple obesity group in NAFLD with metabolic syndrome (Metabolic syndrome, MS) group and simple obesity group. The clinical, biochemical indexes and urinary microalbumin were examined. The clinical, biochemical indexes and urinary microalbumin were compared in each group and their correlation was detected. Results: the urinary microalbuminuria in patients with NAFLD, NAFLD MS over 10 years old and NAFLD were significantly higher than those in obese children, suggesting that there were early renal function damage in NAFLD and NAFLD patients with MS, and increased with age. The early renal damage was more obvious. Urinary microalbumin was positively correlated with systolic blood pressure triglyceride and 2 h postprandial blood glucose (P0.05) suggesting that hypertension and abnormal glucose and lipid metabolism played a role in the early renal dysfunction and the pathogenesis of chronic nephropathy in children. Conclusion: the appearance of NAFLD in obese children is not only an early marker of renal injury, but also an early state of chronic nephropathy. The process of its occurrence and development is significantly related to hypertension and abnormal metabolism of glucose and lipid. Therefore, the early diagnosis and treatment of NAFLD,MS is very important to prevent early renal injury and the development of chronic nephropathy.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R725;R726.9

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