超声衰减成像联合BMI诊断肥胖儿童代谢功能障碍相关性脂肪性肝病价值研究*

doi:10.3969/j.issn.1672-5069.2026.04.012

摘要/Abstract

摘要： 目的探讨超声衰减成像联合体质指数(BMI)诊断肥胖儿童代谢功能障碍相关性脂肪性肝病(MAFLD)的价值。方法 2022年1月～2025年12月我院诊治的129例肥胖儿童和67例非肥胖儿童,分别行超声检查检测肝脏衰减系数(AC)和Fibrotouch检查检测受控衰减参数(CAP)行脂肪变分度。根据血清ALT或/和AST水平诊断代谢功能障碍相关性脂肪性肝炎(MASH)。绘制受试者工作特征(ROC)曲线分析诊断效能。结果在本组129例肥胖儿童中,经检测诊断MASH者58例(45.0%,轻、中、重度脂肪肝分别为26例、20例和12例)和单纯性脂肪肝71例(55.0%);MASH组BMI和AC分别为(30.1±3.4)kg/m²和(0.9±0.2)db/cm/MHz,均显著高于单纯性脂肪肝组【分别为(26.5±2.9)kg/m²和(0.6±0.1)db/cm/MHz,P<0.05】或健康儿童【分别为(23.7±1.7)kg/m²和(0.4±0.1)db/cm/MHz,P<0.05】;重度肝脂肪变的MASH组BMI和AC分别为(33.9±3.6)kg/m²和(1.3±0.4)db/cm/MHz,均显著高于中度组【分别为(30.4±3.4)kg/m²和(1.0±0.2)db/cm/MHz,P<0.05】或轻度组【分别为(25.1±2.0)kg/m²和(0.6±0.1)db/cm/MHz,P<0.05】;ROC分析显示,超声衰减系数联合BMI诊断MASH的曲线下面积(AUC)为0.940(95% CI:0.898～0.981),其灵敏度为79.3%,特异度为98.6%。结论超声衰减成像联合 BMI可帮助临床医生初步判断肥胖儿童 MASH患病情况,为进一步处理提供线索。

Abstract: Objective The purpose of this study was to investigate liver ultrasound attenuation coefficient (AC) and body mass index (BMI) in predicting metabolic dysfunction-associated steatohepatitis (MASH)in obese children. Methods 129 obese children and 67 healthy children were recruited in our hospital between January 2022 and December, and all underwent ultrasonography to detect liver AC, and Fibrotouch to detect controlled attenuation parameter (CAP). MASH was diagnosed by elevation of serum ALT and/or AST levels in children with metabolic dysfunction-associated liver fatty disease (MAFLD). Receiver operating characteristic (ROC) curve was drawn to evaluate predicting efficacy. Results Of the 129 children with MAFLD, MASH was found in 58 cases (45.0%), including mild, moderate and severe liver steatosis in 26 cases, 20 cases and 12 cases, and simple fatty liver (SFL) was found in 71 cases (55.0%); BMI and AC in children with MASH were (30.1±3.4)kg/m² and (0.9±0.2)db/cm/MHz, both significantly higher than [(26.5±2.9)kg/m² and (0.6±0.1)db/cm/MHz, respectively, P<0.05]in those with SFL or [(23.7±1.7)kg/m² and (0.4±0.1)db/cm/MHz, respectively P<0.05]in healthy control; BMI and AC in MASH and severe liver steatosis were (33.9±3.6)kg/m² and (1.3±0.4)db/cm/MHz, both much higher than [(30.4±3.4)kg/m² and (1.0±0.2)db/cm/MHz, respectively, P<0.05]in those with moderate liver steatosis or [(25.1±2.0)kg/m² and (0.6±0.1)db/cm/MHz, respectively, P<0.05] in those with mild liver steatosis; ROC analysis showed that the AUC was 0.940(95% CI:0.898-0.981), with sensitivity of 79.3% and specificity of 98.6%, when AC was combined with BMI in predicting MASH in children with MAFLD. Conclusion Ultrasound-detected AC in combination with BMI could help pediatricians make judgement of MASH in obese children preliminarily, which might provide clues for further managements.

Key words: Metabolic dysfunction-associated fatty liver disease, Ultrasound attenuation imaging, Body mass index, Obesity, Diagnosis, Children

彭艳侠, 翟盟. 超声衰减成像联合BMI诊断肥胖儿童代谢功能障碍相关性脂肪性肝病价值研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 525-528.

Peng Yanxia, Zhai Meng. Liver ultrasound attenuation coefficient and body mass index in predicting metabolic dysfunction-associated steatohepatitis in obese children[J]. Journal of Practical Hepatology, 2026, 29(4): 525-528.

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超声衰减成像联合BMI诊断肥胖儿童代谢功能障碍相关性脂肪性肝病价值研究^*

Liver ultrasound attenuation coefficient and body mass index in predicting metabolic dysfunction-associated steatohepatitis in obese children

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