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Relationship between obesity related indicators and non-alcoholic fatty liver disease in children: a systematic
Ying He1, Liubin Cao1, Chengpei Zhou2
1Department of Forensic Medicine, Medical School, Nantong University, Nantong, China.
Insights
Childhood obesity is linked to nonalcoholic fatty liver disease (NAFLD). Key indicators like BMI, waist circumference, and insulin resistance are higher in children with NAFLD. Exercise can improve NAFLD severity.
Area of Science:
- Pediatrics
- Hepatology
- Metabolic Disorders
Background:
- Rising incidence of childhood obesity.
- Controversy surrounding the association between overweight and pediatric nonalcoholic fatty liver disease (NAFLD).
Purpose of the Study:
- To compare obesity-related parameters in children with and without NAFLD using meta-analysis.
- To provide evidence-based data for clinical practice regarding pediatric NAFLD and obesity.
Main Methods:
- Meta-analysis of 15 original case-control studies.
- Inclusion of 1,595 children (824 NAFLD, 771 controls).
- Statistical analysis using Stata/SE 16.0, SPSS Statistics 26, and Review Manager 5.4.
Main Results:
- Children with NAFLD exhibited significantly higher body mass index (BMI), waist circumference, triglyceride levels, LDL cholesterol, fasting blood glucose, and insulin resistance index compared to controls.
- Meta-analysis revealed significant differences in BMI (MD=1.05), waist circumference (MD=1.66), triglycerides (MD=1.08), LDL (MD=0.49), fasting glucose (MD=0.31), and insulin resistance (MD=2.95).
Conclusions:
- Obesity indicators including BMI, waist circumference, triglycerides, LDL, fasting glucose, and insulin resistance are significantly correlated with NAFLD in children.
- Exercise demonstrated a significant positive effect on improving the degree of steatosis in children diagnosed with NAFLD (OR=2.51).
Background:
The incidence of childhood obesity is increasing. There is some controversy about the association between overweight and nonalcoholic fatty liver disease (NAFLD) in children. This article intends to compare the differences in these obesity related parameters between NAFLD children and healthy control children through meta-analysis to provide evidence-based medical evidence for clinical use.
Methods:
The literature were extracted from English and Chinese databases. Statistical analysis was performed using Stata/SE 16.0, IBM SPSS Statistics 26, and Review Manager 5.4 software.
Results:
A total of 15 original case control studies were included, including 12 high-quality literature, 3 medium quality literature. The total sample size included in the analysis was 1,595 children, including 824 in the experimental group and 771 in the control group. The results of meta-analysis showed that the body mass index (BMI) of the NAFLD group was significantly higher than that of the control group [mean difference (MD) =1.05, 95% confidence interval (CI): 0.36-1.73]. Waist circumference of the NAFLD group was significantly larger than that of the control group (MD =1.66, 95% CI: 0.60-2.73). Triglyceride level in the NAFLD group was significantly higher than that in the control group (MD =1.08, 95% CI: 0.05-2.12). Low-density lipoprotein (LDL) level in the NAFLD group was significantly higher than that in the control group (MD =0.49, 95% CI: 0.12-0.85). In addition, fasting blood glucose of the NAFLD group was significantly higher than that of the control group (MD =0.31, 95% CI: 0.09-0.54) and insulin resistance index of the NAFLD group was significantly higher than that of the control group (MD =2.95, 95% CI: 1.41-4.49). Exercise had a significant effect on improving the degree of NAFLD in children [odds ratio (OR) =2.51, 95% CI: 1.83-3.43].
Conclusions:
Various physical indicators were related to obesity, including BMI, waist circumference, triglyceride content, LDL, fasting blood glucose, and insulin resistance index, and all were significantly correlated with NAFLD in children, provided a reference for future clinical diagnosis and treatment work. In addition, exercise could significantly improve the degree of steatosis in children with NAFLD.
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