Association between visceral adiposity index and non-alcoholic fatty liver among overweight and obese children in Beijing

Abstract

Objective To examine the association between the visceral adiposity index (VAI) and nonalcoholic fatty liver disease (NAFLD) in the pediatric population in order to improve risk stratification and prevention systems for chronic liver disease.

Methods A total of 510 overweight/obese children aged 6–8 years old were enrolled from the child cohort which was designed to study puberty, obesity, and cardiovascular risk (PROC), and complete data from liver ultrasounds and the VAI were obtained. Used Spearman’s rank correlation coefficient, Chi-square tests, and Logistic regression analyses to explore the association between the VAI and NAFLD.

Results The detection rates of NAFLD for boys and girls were 25.9% and 11.1%, respectively. VAI for normal group and the NAFLD group were 0.43 (0.31, 0.61) and 0.61 (0.44, 0.87) in boys, and 0.74 (0.56, 1.07) and 1.08 (0.67, 1.51) in girls, respectively. Spearman’s correlation coefficient analysis showed that triglycerides (TG), VAI, and the third quintile VAI group were positively correlated with NAFLD in both boys and girls ( r=0.19, 0.26, 0.29; 0.16, 0.16, 1.18, P<0.05), and high-density lipoprotein-cholesterol (HDL-C) was negatively correlated with NAFLD in boys ( r=−0.21, P<0.05). With advancing tertiles of VAI, the increasing trend in the NAFLD detection rate was statistically significant in boys and girls ( Chi-square for trend were 21.77, 7.66, P<0.01). The results of univariate and multivariable Logistic regression showed that, by taking the first tertile of VAI as a reference, the risk of NAFLD among boys was higher in the second tertile ( cOR=2.59, 95% CI=1.15–5.86; aOR=2.33, 95% CI=1.01–5.36) and in the third tertile ( cOR=5.73, 95% CI=2.62–12.53; aOR=4.87, 95% CI=2.15–11.03), where as the risk among girls was higher in the third tertile ( cOR=4.43, 95% CI=1.40–14.00).

Conclusion VAI is positively correlated with pediatric NAFLD. Higher tertiles of VAI were associated with an increased risk of NAFLD in overweight and obese children, which indicates that VAI can be used as an early predictor of NAFLD.

Abstract

【摘要】 目的 探索超重肥胖儿童内脏脂肪指数 (visceral adiposity index, VAI) 与非酒精性脂肪肝 (non-alcoholic fatty liver disease, NAFLD) 的关系, 为儿童 NAFLD 早期预防和分层干预提供参考依据。 方法 研究对象来自北京儿童生长与健康 队列 (PROC), 经数据清理整合后纳人具有完整的肝脏超声和 VAI 数据的 6~8 岁超重肥胖儿童 510 名。采用 Spearman 秩 相关分析探索 VAI 与 NAFLD 的相关系数, 采用趋势 χ ² 检验和 Logistic 回归分析确定 VAI 分组与 NAFLD 的关系。 结果 男、女童 NAFLD 检出率分别为 25.9% (69 名) 和 11.1% (27 名)。正常组和 NAFLD 组男童 VAI 为 0.43 (0.31, 0.61) 和 0.61 (0.44,0.87); 女童为 0.74 (0.56, 1.07) 和 1.08 (0.67, 1.51)。男童和女童中三酰甘油 (TG)、VAI 和 VAI 三分位分组与 NAFLD 呈正相关 ( r 值分别为 0.19,0.26,0.29;0.16,0.16,0.18, P 值均<0.05), 男童高密度脂蛋白胆固醇 (HDL-C) 与 NAFLD 呈负相 关 ( r=−0.21, P<0.05)。随着 VAI 分位数的增加, 男女童 NAFLD 检出率有增加的趋势 (X _趋势 ²值分别为21.77,7.66, P 值均< 0.01)。单因素和多因素 Logistic 回归结果显示, 以 VAI 第 1 三分位数为参照, 男童第 2 三分位数 ( cOR=2.59, 95% CI=1.15~5.86； aOR=2.33, 95% CI=1.01~5.36) 和第 3 三分位数 ( cOR=5.73, 95% CI=2.62~12.53； aOR=4.87, 95% CI=2.15~11.03) 患 NAFLD 的风险增加；女童第 3 三分位数 ( cOR=4.43, 95% CI=1.40~14.00) 患 NAFLD 的风险增加。 结论 VAI 与 NAFLD 呈正相关, 超重肥胖儿童患 NAFLD 风险随 VAI 分位数增加而增加, 可应用 VAI 进行 NAFLD 分层管理。