目的: 探讨肥胖儿童微小RNA-122(miR-122)、人去乙酰化酶4(SIRT4)、网膜素-1(Omentin-1)与肥胖程度关系及对非酒精性脂肪肝(NAFLD)的预测效能。方法: 选取2019年8月-2021年6月本院收治的160例肥胖儿童为研究对象,根据其是否发生NAFLD分为NAFLD组58例、非NAFLD组102例。分析两组不同肥胖程度儿童血清miR-122、SIRT4、Omentin-1水平,分析其与肥胖程度、临床指标[尿酸、腰围、体质量、空腹胰岛素(FINS)、甘油三酯(TG)、高密度脂蛋白(HDL)、胰岛素抵抗指数(HOMA-IR)]对NAFLD的预测价值。结果: 与非NAFLD组比较,NAFLD组血清miR-122水平升高(P＜0.05),SIRT4、Omentin-1水平降低(P＜0.05);血清miR-122水平随着肥胖程度增加而升高(P＜0.05),SIRT4、Omentin-1水平随着肥胖程度增加而降低(P＜0.05); miR-122水平与肥胖程度、尿酸、腰围、体质量、FINS、TG、HOMA-IR呈正相关,与HDL呈负相关(P＜0.05);SIRT4、Omentin-1与肥胖程度、尿酸、腰围、体质量、FINS、TG、HOMA-IR呈负相关,与HDL呈正相关(P＜0.05);联合预测NAFLD的AUC大于单项预测(P＜0.05)。结论: NAFLD儿童血清miR-122水平升高,SIRT4、Omentin-1水平降低,其与肥胖程度、脂质代谢、胰岛素抵抗密切相关,联合检测其水平对肥胖儿童NAFLD的发生具有一定预测价值。

Objective: To investigate the relationship between microRNA-122 (miR-122), Sirtuin 4 (SIRT4) and Omentin-1 (Omentin-1) with obesity degree in obese children, and to explore the predictive efficacy of them in nonalcoholic fatty liver disease (NAFLD). Methods: A total of 160 obese children admitted to our hospital from August 2019 to June 2021 were selected as the research objects. 160 obese children were divided into NAFLD group(n=58) and non-NAFLD group(n=102) according to whether they had NAFLD or not. The levels of serum miR-122, SIRT4, and Omentin-1 in the two groups were observed, and their correlation with the degree of obesity and clinical indicators [uric acid, waist circumference, body mass, fasting insulin (FINS), triglyceride (TG), high-density lipoprotein (HDL), insulin resistance index (HOMA-IR)]. Results: Compared with the non-NAFLD group, the serum miR-122 level in the NAFLD group increased (P＜0.05), while the levels of SIRT4 and Omentin-1 decreased (P＜0.05). The serum miR-122 level of the NAFLD group increased with the raising degree of obesity (P＜0.05), but the levels of SIRT4 and Omentin-1 decreased with the raising degree of obesity (P＜0.05). The level of miR-122 was positively correlated with the degree of obesity, uric acid, waist circumference, body mass, FINS, TG and HOMA-IR, but negatively correlated with HDL (P＜0.05). SIRT4 and Omentin-1 levels were negatively correlated with obesity degree, uric acid, waist circumference, body mass, FINS, TG and HOMA-IR, but positively correlated with HDL (P＜0.05). The combined prediction AUC for NAFLD was higher than single prediction (P＜0.05). Conclusion: The level of serum miR-122 in NAFLD children is increased, while the levels of SIRT4 and Omentin-1 are decreased, which are closely related to the degree of obesity, lipid metabolism and insulin resistance. The combined detection of microRNA-122, Sirtuin 4 and Omentin-1 level has certain value for predicting the occurrence of NAFLD in obese children.