关联社区层面的贫困和儿科代谢功能障碍相关的脂肪性肝病
Nicole E Hickman1,2, Mason Price1, Noe C Crespo3
1San Diego School of Medicine, University of California, La Jolla, California, USA.
Journal of pediatric gastroenterology and nutrition
|April 16, 2024
概括
邻居剥夺并没有恶化儿科代谢功能障碍相关的脂肪性肝病 (MASLD) 的严重程度. 然而,较高的区域剥夺指数 (ADI) 分数与患有MASLD的儿童的维生素D和高密度脂蛋白 (HDL) 水平较低有关.
科学领域:
- 儿科肝病学 儿科肝病学
- 与代谢功能障碍相关的脂肪性肝病 (MASLD)
- 健康的社会决定因素
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 在儿童中越来越普遍.
- 健康的社会决定因素,如社区贫困,可能会影响疾病的表现和严重程度.
- 区域贫困指数 (ADI) 量化了社区层面的社会经济劣势.
研究的目的:
- 通过使用ADI得分,调查邻里贫困与儿科MASLD患者在呈现时的疾病严重性标志物之间的联系.
- 探索ADI如何与儿科MASLD的临床症状学,实验室值和肝活检发现有关.
主要方法:
- 对344名儿科MASLD患者进行了回顾性横截面研究.
- 根据邮政编码,患者被分配一个ADI得分,并分为低 (≤5) 和高 (≥6) ADI组.
- 统计分析包括ANCOVA,千二测试和后勤回归来评估ADI和疾病特征之间的关联.
主要成果:
- 在低和高ADI组之间,没有观察到年龄,表现类型或相关疾病的显著差异.
- 高ADI群体的维生素D水平显著降低 (p=0.02),低高密度脂蛋白 (HDL) 水平的可能性是两倍 (p=0.04).
- 肝活检上的平均转氨酶和NAFLD活性评分在ADI组之间没有显著差异.
结论:
- 这个队列中的小儿MASLD患者代表了广泛的社区贫困.
- 虽然在高ADI组中观察到较低的维生素D和HDL水平,但区域剥夺并不是基于转氨酶和肝脏活检得分的更严重MASLD的预测因素.
- 需要进一步的研究,以了解关联社会经济因素与儿童代谢性肝病的具体机制.
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