弹性成像是筛查小儿阻塞性睡眠呼吸暂停成人表型非酒精性脂肪肝的无创方法

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2024-09-12 DOI:10.1007/s11325-024-03149-3

Anna Durdikova, Peter Durdik, Marek Prso, Dominika Dvorska, Lukas Remen, Jarmila Vojtkova, Filip Oleksak, Peter Banovcin

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引用次数: 0

摘要

目的患有阻塞性睡眠呼吸暂停（OSA）的肥胖儿童中非酒精性脂肪肝（NAFLD）的发病率很高，因此需要进行早期无创筛查。本研究的目的是利用超声肝脏回声和弹性来评估患有 OSA 的肥胖儿童肝脏损伤的早期阶段。对照组（n = 56）由健康的非肥胖儿童组成。所有儿童都接受了超声波检查，通过肝肾指数（HRI）评估肝脏回声，并通过实时弹性成像测定肝纤维化指数（LFI）。根据 OSA 及其严重程度对多导睡眠图参数、超声波检查值和临床生化评估进行了统计分析。结果患有 OSA 的肥胖儿科患者组的 HRI 和 LFI 平均值较高（平均年龄 ± SD，14.与对照组相比（1.37 ± 0.19 vs. 1.12 ± 0.07，p <0.001；1.82 ± 0.31 vs. 1.02 ± 0.27，p <0.001），肥胖儿童 OSA 患者组的 HRI 和 LFI 平均值更高（平均年龄 ± SD，14.1 ± 2.2 岁；53% 为男性；BMI z-score，2.6 ± 0.35）。与亚组 1 相比，亚组 2 的 LFI 明显更高（2.0 ± 0.3 vs. 1.6 ± 0.2，p < 0.001），而实验室参数和 HRI（1.4 ± 0.2 vs. 1.4 ± 0.2，p = 0.630）没有明显变化。结论：这些研究结果表明，超声弹性成像是筛查肥胖青少年中与 OSA 相关的脂肪性肝炎的一种有效的无创检测方法，但还需要其他临床研究来证实这一结果。

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Elastography as a non-invasive method of screening non-alcoholic fatty liver disease in the adult phenotype of paediatric obstructive sleep apnoea

Purpose

The high prevalence of non-alcoholic fatty liver disease (NAFLD) in obese children with obstructive sleep apnoea (OSA) calls for early non-invasive screening. The aim of this study was to use ultrasonographic liver echogenicity and elasticity to evaluate the early stages of liver injury in obese children with OSA.

Methods

Fifty-five obese children with OSA aged 12 to 15 years were included. The control group (n = 56) consisted of healthy, non-obese children. All children underwent ultrasound examination to assess liver echogenicity using the hepatorenal index (HRI) and real-time elastography to determine the liver fibrosis index (LFI). Polysomnographic parameters, sonographic values, and clinical-biochemical assessment were statistically analysed according to OSA and its severity. Subgroup 1 was obese children with OSA and AHI < 5 and subgroup 2 was obese children with OSA and AHI ≥ 5.

Results

Higher average values of HRI and LFI were recorded in the group of obese paediatric patients with OSA (mean age ± SD, 14.1 ± 2.2 year; 53% male; BMI z-score, 2.6 ± 0.35) compared to the control group (1.37 ± 0.19 vs. 1.12 ± 0.07, p < 0.001 and 1.82 ± 0.31 vs. 1.02 ± 0.27, p < 0.001). A significantly higher LFI was recorded in subgroup 2 compared to subgroup 1 (2.0 ± 0.3 vs. 1.6 ± 0.2, p < 0.001) while laboratory parameters and HRI (1.4 ± 0.2 vs. 1.4 ± 0.2, p = 0.630) did not change significantly. A strong positive correlation was found between the severity of OSA and the LFI (r = 0.454; p < 0.01).

Conclusions

These findings suggest that ultrasound elastography is a useful non-invasive screening test for OSA-related steatohepatitis in obese adolescents, but other clinical studies are needed to confirm this result.

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.