Clinical epidemiology of metabolic-associated fatty liver disease in overweight and obese children

Abstract

Background. Metabolic-associated fatty liver disease (MAFLD) is one of the leading causes of chronic liver diseases in overweight/obese children. The aim was to study the frequency of MAFLD and to identify the risk factors that are potentially associated with this disease in overweight/obese children. Materials and methods. The study was conducted in 2020–2023. Inclusion criteria were body mass index > 85th percentile for age/gender, child’s age from 6 to 18 years. We used screening criteria to diagnose MAFLD: an increased level of alanine aminotransferase (ALT) > 80 U/L at the first visit, or a persistently elevated (> 3 months) ALT level to twice the upper limit of normal (in girls, ALT ≥ 44 U/L, in boys, ALT ≥ 52 U/L). At the second stage of the study, we analysed factors potentially associated with MAFLD. All stages of the work were carried out taking into account the bioethical norms of the Declaration of Helsinki. Results. MAFLD is a common metabolic condition in overweight/obese children and its frequency in the studied cohort was 22 %. The development of MAFLD in overweight/obese children is associated with the following factors: male gender (odds ratio (OR) = 2.06), intrauterine growth restriction (OR = 4.09), formula feeding (OR = 2.54), family history of type 2 diabetes (OR = 2.55), high consumption of foods rich in carbohydrates (OR = 3.31), sedentary lifestyle (OR = 10.16), obesity (OR = 48.15), prehypertension (OR = 4.41), prediabetes/type 2 diabetes (OR = 2.37), vitamin D deficiency (OR = 2.40). Conclusions. The inclusion of the above-mentioned risk factors in the screening algorithm for overweight/obese children will help in early detection, treatment and prevention of MAFLD in this age cohort.

Keywords

• children
• overweight/obesity
• metabolic-associated fatty liver disease