单核细胞/高密度脂蛋白胆固醇 (HDL-C) 比值对肥胖儿童和青少年小儿代谢相关性脂肪肝的诊断性能

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2024-07-27 DOI:10.5812/ijp-145607

Yavuz Ozer, Dilek Bingol Aydın

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引用次数: 0

摘要

背景：儿童肥胖症的发病率不断上升，使小儿代谢相关性脂肪肝（MAFLD）成为最受关注的健康问题之一。调查目的本研究旨在探讨肥胖儿童和青少年的代谢相关性脂肪肝与单核细胞-高密度脂蛋白胆固醇比值（MHR）之间的关系。研究方法在这项回顾性研究中，我们对 2022 年 10 月 1 日至 2023 年 9 月 30 日期间 6-18 岁肥胖儿童和青少年中 MAFLD 和非 MAFLD 病例的 MHR 值进行了比较分析。为了确定 MHR 与 MAFLD 的预后价值，我们采用了 ROC 分析法。此外，我们还利用逻辑回归分析来研究每个变量与 MAFLD 之间的关联。结果研究共纳入了 211 名确诊为肥胖症的儿童（67 名男孩和 144 名女孩），其中包括 121 名 MAFLD 患者和 90 名单纯肥胖症对照组。与单纯肥胖组相比，MAFLD 组的单核细胞/高密度脂蛋白胆固醇比率明显更高（0.56 ± 0.19 vs. 0.46 ± 0.14，P < 0.001）。MHR与空腹胰岛素、HOMA-IR、TG/HDL-C、TyG、甘油三酯水平和肝脂肪变性程度呈正相关（分别为P = 0.011，r = 0.184；P = 0.029，r = 0.159；P < 0.001，r = 0.374；P = 0.005，r = 0.203；P < 0.001，r = 0.257；P < 0.001，r = 0.272）。ROC曲线分析显示，MHR预测MAFLD的临界值为0.43（×109/mmol），灵敏度为75.45%，特异度为46.34%。MHR区分MAFLD患儿和非MAFLD患儿的曲线下面积为0.656（P = 0.002）。逻辑回归分析表明，男性（OR：3.825；P = 0.001）、高 ALT（OR：1.035；P = 0.025）和高 MHR（OR：16.166；P = 0.025）与 MAFLD 存在显著正相关。结论我们确定了肥胖儿童和青少年的 MHR 与 MAFLD 之间的相关性。高 MHR 与罹患 MAFLD 的风险明显相关。单核细胞/高密度脂蛋白胆固醇比值是一种无创标记物，可用作预测 MAFLD 的炎症生物标记物。

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Diagnostic Performance of the Monocyte/High-Density Lipoprotein Cholesterol (HDL-C) Ratio for Pediatric Metabolic Associated Fatty Liver Disease in Children and Adolescents with Obesity

Background: The escalating prevalence of childhood obesity has rendered pediatric metabolic-associated fatty liver disease (MAFLD) one of the foremost health concerns. Objectives: This investigation aims to examine the relationship between MAFLD and the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in children and adolescents with obesity. Methods: In this retrospective study, we conducted a comparative analysis of MHR values for MAFLD and non-MAFLD cases in children and adolescents with obesity, aged 6 - 18, from 1 October, 2022 to 30 September 2023. To determine the prognostic value of MHR in relation to MAFLD, we implemented ROC analysis. Additionally, logistic regression analysis was utilized to examine the association between each variable and MAFLD. Results: A total of 211 children diagnosed with obesity (67 boys and 144 girls) were included in the study, comprising 121 MAFLD patients and 90 simple obesity controls. The monocyte/HDL-C ratio was significantly higher in the MAFLD group compared to the simple obesity group (0.56 ± 0.19 vs. 0.46 ± 0.14, P < 0.001). There was a positive correlation between MHR and fasting insulin, HOMA-IR, TG/HDL-C, TyG, triglyceride levels, and the grade of hepatosteatosis (P = 0.011, r = 0.184; P = 0.029, r = 0.159; P < 0.001, r = 0.374; P = 0.005, r = 0.203; P < 0.001, r = 0.257; P < 0.001, r = 0.272, respectively). The ROC curve analysis revealed that the cut-off value for MHR to predict MAFLD was 0.43 (× 109/mmol), with a sensitivity of 75.45% and a specificity of 46.34%. The area under the curve for MHR in distinguishing children with MAFLD from those without was 0.656 (P = 0.002). Logistic regression analysis indicated that male gender (OR: 3.825; P = 0.001), high ALT (OR: 1.035; P = 0.025), and high MHR (OR: 16.166; P = 0.025) had significant positive associations with the presence of MAFLD. Conclusions: We established a correlation between MHR and MAFLD in children and adolescents with obesity. High MHR was significantly related to the risk of MAFLD. The monocyte/HDL-C ratio, a noninvasive marker, may be used as an inflammatory biomarker in predicting MAFLD.

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.