目的 比较肥胖伴非酒精性脂肪肝(NAFLD)和肥胖不伴NAFLD儿童的临床数据和血清脂质差异,探索脂质代谢物对儿童肥胖并发NAFLD的诊断价值。方法 收集2023年9—12月在西安交通大学第二附属医院儿科门诊就诊的肥胖伴NAFLD儿童12例和肥胖不伴NAFLD儿童16例,对每位儿童进行体格检查和血液生化检查。应用液相色谱-质谱联用技术(LC-MS)对血清进行非靶向脂质组学研究;使用Lipidsearch和MetaboAnalyst 6.0对脂质组学数据进行多元统计分析。采用ROC曲线评估脂质对肥胖儿童NAFLD的诊断价值。结果 肥胖伴NAFLD组患儿体质量指数(BMI)(t=2.605)和谷丙转氨酶(Z＝2.351)均显著高于不伴NAFLD组(P<0.05)。偏最小二乘判别分析显示脂质组学可以显著区分两组儿童。相较于肥胖不伴NAFLD组,甘油三酯在肥胖伴NAFLD显著升高,而O酰基-ω羟基脂肪酸(OAHFA)亚类则显著降低(P<0.05)。与肥胖不伴NAFLD组相比,肥胖伴NAFLD儿童的磷脂酰乙醇胺PE(18:0e_22:5)、磷脂酰胆碱PC(37:4e)、磷脂酰胆碱PC(20:4e_15:0)、鞘磷脂phSM(d20:0_16:0)、单己糖神经酰胺Hex1Cer(t20:0_22:6)、心磷脂CL(83:13)显著降低(P<0.05)。ROC曲线提示6种脂质候选标志物的曲线下面积均显著高于ALT,对肥胖儿童NAFLD的诊断有一定价值。结论 肥胖伴NAFLD和不伴NAFLD儿童脂质组学存在明显差异,脂代谢紊乱与肥胖儿童NAFLD发病相关,筛选获得的脂质代谢物在肥胖儿童NAFLD的诊断中具有重要价值。
Abstract
Objective To compare the clinical data and serum lipid profiles between obese children with nonalcoholic fatty liver disease (NAFLD) and those without NAFLD, and to explore the diagnostic value of lipid lipid metabolites in NAFLD in obese children. Methods A total of 12 obese children diagnosed with NAFLD and 16 obese children without NAFLD in the Pediatric Outpatient Department of Xi′an Jiaotong University Second Hospital from September to December in 2023 were enrolled in this study. Each child underwent a physical examination and blood biochemical tests. Multivariate statistical analysis of lipidomic data was conducted using Lipidsearch and MetaboAnalyst 6.0. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of lipid markers for NAFLD in obese children. Results Body mass index (BMI)(t=2.605)and alanine aminotransferase (ALT)(Z=2.351) levels were significantly higher in obese children with NAFLD compared to those without NAFLD (P<0.05). Partial least squares discriminant analysis (PLS-DA) indicated that lipidomics could effectively differentiate between the two groups. In the obese group with NAFLD, triglyceride (TG) levels were significantly elevated, while the subclasses of O-acyl-ω-hydroxy fatty acids (OAHFA) were significantly reduced compared to the obese group without NAFLD (P<0.05). Additionally, the levels of phosphatidylethanolamine (PE) (18:0e_22:5), phosphatidylcholine (PC) (37:4e), phosphatidylcholine (PC) (20:4e_15:0), phytosphingosine (phSM) (d20:0_16:0), monosaccharide ceramide (Hex1Cer) (t20:0_22:6), and cardiolipin (CL) (83:13) were significantly decreased in obese children with NAFLD(P<0.05). The ROC curve analysis revealed that the area under the curve for the six lipid candidate markers was significantly greater than that for ALT, indicating their potential diagnostic value for NAFLD in obese children. Conclusions There are significant differences in lipidomic profiles between obese children with and without NAFLD. Disorders in lipid metabolism are associated with the development of NAFLD in obese children, and the identified lipid metabolites possess important diagnostic value for NAFLD in this population.
关键词
儿童肥胖 /
非酒精性脂肪肝 /
脂质组学
Key words
childhood obesity /
non-alcoholic fatty liver /
lipidomics
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基金
国家自然科学基金(82373594,81903340);陕西省自然科学基础研究基金(2020JQ-549);西安交通大学第二附属医院IIT临床研究基金(T007)
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