Development and validation of a simple index system to predict nonalcoholic fatty liver disease / 대한간학회지

BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. METHODS: The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. RESULTS: Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; gamma-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2< or =BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. CONCLUSIONS: NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.

The Factors Associated with Becoming Obese Children: in 6th Grade Children of Elementary Schools in Busan

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.

Parental perception on childhood obesity according to weight status in children of elementary schools in Busan

BACKGROUND: It has been found that parental role is essential for obesity management in childhood. However, there are few studies concerning parental perception on childhood obesity in Korea. Parental perception on childhood obesity according to weight status in elementary school children was examined. METHODS: The subjects were 3,996 elementary school children and their parents in Busan. The surveys which included socioeconomic characteristics, children's eating habits and activities, parental weight and height, parental perception on childhood obesity, were filled out by parents. Children's body mass index (BMI) were calculated using the height and weight measured in school children were classified into the obese group (BMI 95 Percentile) , the high risk group (85 percentile BMI <95 percentile) and the normal weight group (85 percentile) according to BMI gender and age. The analyses were done using x2_ test and ANOVA. RESULTS: Parental BMI in the obese group was higher than the normal weight group in boys a girls (P<0.001) . Participation in regular exercise was higher among the obese group compared to the normal weight group regardless of sex, but daily exercise time was lesser among the obese group only in boys (P <0.001) . Daily TV watching time was not different according to weight status in both sex. The parents with obese children perceived their children's weight as an appearance problem or a health problem about 7-18 times more likely than the parents of children with normal weight. 70% of obese children have tried weight control. The proportion of parental understanding on childhood obesity as a disease was not different among boys, but different among girls (P<0.001) . Eighty five percents of the parents perceived childhood obesity as a disease or a risk factor. But, their perception for the association of hypertension, fatty liver, sleep apnea syndrome with obesity was relative low. CONCLUSION: Most parents with obese children perceived childhood obesity as an appearance problem, a health problem and as a disease or a risk factor.