| Objective To explore the correlation between serum uric acid and sex hormone levels and non-alcoholic fatty liver disease (NAFLD) in obese children.Methods The clinical data of 124 obese children admitted to the Lianyungang First People's Hospital from January 2021 to July 2023 were collected. Gender, age, height, weight, body mass index (BMI), white blood cells (WBC), C-reactive protein (CRP), fasting blood glucose (FBG), fasting insulin (FINS), fasting C-peptide, and insulin resistance index (HOMA-IR),glycosylated hemoglobin (HbA1c), serum uric acid (SUA), liver function, six items of sex hormones, thyroid function (TSH, FT3, FT4)and other related indicators were retrospectively analyzed. According to the results of fasting ultrasound, the children were divided intotwo groups: obesity group and obesity combined with NAFLD. Comparison and correlation analysis between various indicators were conducted between groups. The risk factors for NAFLD in children were calculated by binary logistic regression model, and the subjects'operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of different factors on NAFLD.Results There was no significant difference in sex, age and height between the two groups (P>0.05). Obese children with NAFLD had higher BMI [(31.59±4.39) kg/m2 vs. (29.53±5.05) kg/m2], FINS [31.45 (23.33, 43.06) mIU/L vs. 20.79 (15.72,35.72) mIU/L], HOMA-IR [6.89 (4.96, 10.29) vs. 4.92 (3.26, 7.85)], fasting C-peptide [1 386.50 (1 088.00, 1617.75) pmol/L vs. 1 056.00 (787.40, 1 488.25) pmol/L], WBC [(7.84±1.79)×109/L vs. (7.08±1.55)×109/L], CRP [2.57 (1.21, 3.59) mg/L vs. 1.58 (0.99, 2.64) mg/L], SUA [(449.35±98.55)μmol/L vs. (398.64±91.60) μmol/L], HbA1c [5.40 (5.30, 5.70) % vs. 5.30 (5.10, 5.47) % ], triglyceride (TG) [1.33 (0.95, 1.92) mmol/L vs. 0.99 (0.80, 1.51) mmol/L], ALT [38.50 (24.50, 70.00) U/L vs. 18.00 (14.00, 28.25) U/L], AST [29.00 (23.25, 44.50) U/L vs. 20.00 (17.00, 25.75) U/L], TSH [3.23 (2.39, 4.58) mIU/L vs. 2.60 (2.18, 3.78) mIU/L], while high-density lipoprotein (HDL) [(1.04±0.20) mmol/L vs. (1.15±0.25) mmol/L] and sex hormone binding spheres protein (SHBG) [13.35 (10.47, 16.60) nmol/L vs. 19.65 (13.87, 27.20) nmol/L] inchildren with NAFLD were lower than those in the control group. There was significant difference between the two groups (P<0.05). Correlation analysis found that SUA levels in obese children with NAFLD were negatively correlated with HLD (r=?0.26) and SHBG (r= ?0.24); obese children with NAFLD SHBG levels in children are negatively correlated with BMI (r=?0.35), FINS (r=?0.39), HOMR-IR (r=?0.36), fasting C-peptide (r=?0.45), CRP (r=?0.22), SUA (r=?0.24), TG (r=?0.22), ALT (r=?0.28), AST (r=?0.23). Further logistic regression analysis showed that WBC [OR=1.51,95%CI: (1.20, 2.07), ALT [OR=1.05, 95%CI: (1.01, 1.20)] and SHBG [OR=0.92, 95% CI:(0.86, 0.98)] were risk factors for obesity complicated with NAFLD. After drawing the ROC curve, it was found that the area underthe NAFLD curve predicted by SHBG was 0.73, 95%CI:(0.64, 0.82), the best cut-off value was 18.50, the sensitivity was 86.1%, andthe specificity was 53.8%. The area under the NAFLD curve predicted by ALT was 0.81, 95%CI: (0.73, 0.88), the best cut-off value is 21.50, the sensitivity was 84.7%, the specificity is 63.5%.The area under the NAFLD curve predicted by WBC was 0.61, 95%CI: (0.51, 0.91), the best cut-off value was 7.64, the sensitivity was 51.4%, and the specificity was 67.3%. The combination of the three predictedthe area under the NAFLD curve was 0.84, 95%CI: (0.76, 0.91), the sensitivity was 86.1%, and the specificity was 69.2%. Conclu? sions There is a correlation between SUA and childhood obesity complicated with NAFLD. Low level of SHBG is an independent riskfactor for obese children with NAFLD and can be used as a predictor of NAFLD. |
