비만을 동반한 소아 지방간 환아에서 체질량 지수, 체지방 분포, 간 효소치 및 복부 CT 소견과의 상관관계에 대한 연구

Correlation of Body Mass Index, Body Fat Distribution, Aminotranferases and Computed Tomography in Obese Children with Fatty Liver

  • 박소은 (서울대학교 의과대학 소아과학교실) ;
  • 양혜란 (서울대학교 의과대학 소아과학교실) ;
  • 장주영 (서울대학교 의과대학 소아과학교실) ;
  • 고재성 (서울대학교 의과대학 소아과학교실) ;
  • 서정기 (서울대학교 의과대학 소아과학교실) ;
  • 이활 (서울대학교 의과대학 방사선과학교실) ;
  • 김우선 (서울대학교 의과대학 방사선과학교실)
  • Park, So Eun (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Yang, Hye Ran (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Chang, Ju Young (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Ko, Jae Sung (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Seo, Jeong Kee (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Whal (Department of Radiology, Seoul National University College of Medicine) ;
  • Kim, Woo Sun (Department of Radiology, Seoul National University College of Medicine)
  • 투고 : 2004.09.15
  • 심사 : 2004.10.13
  • 발행 : 2005.03.15

초록

목 적 : 내장 지방은 비만 합병증의 위험 인자이며 성인에서 지방간은 내장 지방과 관련이 있음이 알려져 있다. 소아 비만의 진단기준인 BMI가 내장 지방 정도를 반영하는지를 살펴보고 소아 지방간 환아에서 BMI, 체지방 분포, 간 효소치와 복부 CT상 지방간 정도 사이의 상관관계를 알아보고자 하였다. 방 법 : 2000년 1월부터 2004년 2월까지 BMI를 기준으로 비만위험 또는 비만에 동반된 간 효소치 이상을 주소로 서울대학교 어린이병원 소아과에 내원하여 비조영증강 복부 CT 검사로 지방간을 진단받은 소아 23례(남아 19명, 여아 4명)를 대상으로 하여 CT로 복부 지방 면적을 측정하였다. BMI와 내장 지방과의 상관관계, 복부 CT상 지방간의 정도와 BMI, VAT, VSR, 간 효소치간의 상관관계를 분석하였다. 결 과 : BMI는 TAF(r=0.91476, P<0.0001), VAT(r=0.51719, P=0.0115), SAAT(r=0.88302, P<0.0001)와 유의한 상관관계가 있었다. CTL/CTS비와 BMI(r=-0.11938, P=0.5876), TAF(r=-0.14936, P=0.4964), VAT(r=-0.31234, P=0.1468), SAAT(r=-0.08154, P=0.7115), VSR(r=-0.19202, P=0.3801), AST(r=0.12729, P=0.5628), ALT(r=-0.00179, P=0.9935) 및 AST/ALT비(r=0.20762, P=0.3418) 사이에 유의한 상관관계가 없었다. 결 론 : 소아 비만에서 BMI는 내장 지방 정도를 반영하나 복부 CT상 지방간의 정도와 간 효소치, BMI, 내장 지방량 사이에 유의한 상관관계가 없었다.

Purpose : Visceral fat accumulation plays a major role in metabolic complications of obesity. It is known that nonalcoholic fatty liver in obese adults is associated with visceral fat accumulation. Body mass index(BMI) is used as the index of obesity in children. The aim of this study is to evaluate the correlation of BMI and visceral adipose tissue(VAT), and the correlation of BMI, body fat distribution, aminotransferases, and severity of fatty liver. Methods : Twenty three obese children with fatty liver diagnosed by non-contrast abdominal computed tomography(CT) were included in this study. Data on BMI, aminotransferase levels were collected from clinical records. Visceral adipose area was evaluated with CT. Results : BMI had a singnificant correlation with VAT(r=0.51719, P=0.0115). The severity of fatty liver had no significant correlations with BMI(r=-0.11938, P=0.5876), VAT(r=-0.31234, P=0.1468), aspartate aminotransferase(AST)(r=0.12729, P=0.5628) or alanine aminotransferase(ALT)(r=-0.00179, P=0.9935). Conclusion : BMI in obese children was correlated with VAT. But the severity of fatty liver cannot be assessed by BMI, VAT or aminotransferase levels.

키워드

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