摘要目的:分析肥胖儿童非酒精性脂肪性肝炎的相关因素。方法:回顾性分析2020年7月至2021年1月在杭州师范大学附属医院儿童肥胖门诊就诊的91例肥胖儿童的临床资料，根据有无非酒精性脂肪性肝炎进行分组，记录两组患儿年龄、性别、体质指数、血25羟基维生素D3、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白、空腹胰岛素、受控衰减参数、肝脏硬度值等临床资料。对两组的各临床指标采用单因素分析后，有统计学意义的指标纳入二元logistic回归分析，探讨肥胖儿童非酒精性脂肪性肝炎的相关因素并绘制受试者工作特征曲线（ROC曲线）。结果:91例患儿就诊年龄6岁1个月至14岁11个月，男女比例1.33∶1，诊断为非酒精性脂肪性肝病为46例，其中非酒精性脂肪性肝炎13例（14.3%），包括男9例，女4例。单因素分析显示，两组性别、年龄、空腹胰岛素、受控衰减参数、肝脏硬度值比较差异均有统计学意义（均 P<0.05）。logistic回归分析显示，受控衰减参数（ OR=1.022，95% CI：1.003~1.041）和肝脏硬度值（ OR=1.689，95% CI：1.077~2.648）是肥胖儿童非酒精性脂肪性肝炎的相关因素（均 P<0.05）。受控衰减参数及肝脏硬度预测肥胖儿童非酒精性脂肪性肝炎的曲线下面积（AUC）分别为0.840（95% CI：0.748~0.931）和0.794（95% CI：0.672~0.915）。 结论:受控衰减参数、肝脏硬度值与肥胖儿童非酒精性脂肪性肝炎有相关性且对其具有诊断价值。

abstractsObjective:To investigate the related factors of nonalcoholic steatohepatitis in children with obesity.Methods:A retrospective analysis was performed on 91 children with obesity who visited the Pediatric Obesity Clinic in the Affiliated Hospital of Hangzhou Normal University from July 2020 to January 2021. The 91 children with obesity were divided into two groups: with or without nonalcoholic steatohepatitis. Age, gender, body mass index, blood 25 hydroxyvitamin D3, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein, fasting insulin, control attenuation parameter and liver hardness value of in the 2 groups were recorded. Univariate analysis of the clinical data of the two groups was performed, and the clinical data with statistically significant differences between the two groups were included in binary logistic regression analysis to explore the related factors of nonalcoholic steatohepatitis in children with obesity. And then the receiver operating characteristic curve (ROC curve) was drawn on the relevant factors.Results:The children with obesity received treatment at the age of 6 years 1 month to 14 years 11 months, the male to female ratio was 1.33∶1. And 13 children (14.3%) were diagnosed with non-alcoholic steatohepatitis, of 46 nonalcoholic fatty liver disease, 9 were male and 4 were female. Univariate analysis showed that there were significant differences in gender, age, fasting insulin, control attenuation parameter and liver hardness value between the two groups (all P<0.05). Binary logistic regression analysis showed that control attenuation parameter ( OR=1.022, 95% CI: 1.001-1.041) and liver hardness value ( OR=1.689, 95% CI: 1.077-2.648) were the related factors of nonalcoholic steatohepatitis in children with obesity (both P<0.05). The area under the curve (AUC) values of control attenuation parameter and liver hardness value for predicting nonalcoholic steatohepatitis in children with obesity was 0.840 (95% CI: 0.748-0.931) and 0.794 (95% CI: 0.672-0.915), respectively. Conclusion:Control attenuation parameter and liver hardness value are correlated with nonalcoholic steatohepatitis in children with obesity with certain diagnostic value.