비만 소아에서 혈중 아디포넥틴과 비알콜성지방간질환과의 관계 = The Relationship between Serum Adiponectin and Non-Alcoholic Fatty Liver Disease in Obese Children

국문 초록 (Abstract)

연구배경: 본 연구에서는 비만 소아에서 혈중 아디포넥틴을 측정하여 비알콜성지방간질환과의 상관성을 알아보고자 하였다.
방법: 비만 소아 63명과 과체중 소아 17명, 정상 체중 소아 31명 총 111명을 대상으로 신체계측과 혈압, 혈당, 혈중 간기능 검사와 지질치, 인슐린, 아디포넥틴을 측정하였고 비만아 49명에게 복부 초음파를 시행하여 지방간 발생유무를 조사하였다.
결과: ALT는 정상 체중군, 과체중군, 비만군에서 각 군 간에 유의한 차이가 있었으며, 비만군이 높았다. 총 콜레스테롤, LDL 콜레스테롤도 3군 간에 유의하게 차이가 있었으나 중성지방, HDL 콜레스테롤은 각 군 간 차이가 없었다. 아디포넥틴 역시 각 군 간에 유의한 차이가 있었으며 비만군에서 낮았다. 아디포넥틴은 체질량지수, AST, ALT, 총 콜레스테롤, LDL 콜레스테롤, 인슐린, HOMA-IR와 역상관관계를 보였다. 비만아 중 비알콜성지방간염으로 추정할 수 있는 경우는 34.7%이었으며, 비알콜성지방간염으로 추정되는 비만아가 정상 간의 비만아 비해 혈중아디포넥틴은 낮았다.
결론: 비만 소아에서 낮은 혈중 아디포넥틴이 비알콜성지방간질환 특히 비알콜성지방간염의 발생과 연관이 있는것으로 추측되며 이에 대한 적극적인 검사가 필요하다고 생각한다

다국어 초록 (Multilingual Abstract)

Background: In obese adults, non-alcoholic steatohepatitis (NASH) is closely associated with adiponectin and insulin resistance. We investigated the relationship of serum adiponectin with non-alcoholic fatty liver disease in obese children.
Method: The study population consisted of children from 7 to 15 years old. We measured 8 hour fasting serum glucose, liver enzymes, insulin, adiponectin and lipid profile. We performed ultrasonography to evaluate the fatty liver in 49 obese children.
Results: 1) Mean body mass index was 23.95 kg/m2.
2) Alanine aminotransferase (ALT) was 14.16 IU/L in normal weight, 44.65 IU/L in overweight, 46.71 IU/L in obese children. There were significant differences in total cholesterol, LDL-cholesterol among normal weight, overweight, obese children. 3) Serum adiponectin was 30.63 μg/mL in normal weight, 24.05 μg/mL in overweight and 20.84 μg/mL in obese children. 4) Among the obese children, 17 subjects (34.7%) were presumed to have NASH. Reduced serum adiponectin level was noted among obese children with presumed NASH in contrast to those of obese children with normal liver.
Conclusion: In this study, decreased adiponectin level had closely related with presumed NASH in obese children. Our results suggest that adiponectin plays an important role in the development of NASH in obese children.

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