J Pediatr (Rio J). 2026 Mar 17:101534. doi: 10.1016/j.jped.2026.101534. Online ahead of print.
ABSTRACT
OBJECTIVES: The increasing prevalence of metabolic dysfunction associated with steatotic liver disease (MASLD) is consistent with the global obesity epidemic. The aim of the study was to investigate the presence of MASLD in a high-risk group of children and to compare cardiovascular risk factors between the groups with and without MASLD, in addition to investigating potential biomarkers.
METHODS: This cross-sectional study was carried out at a public institution with thirty-eight patients (19 girls, 13.2 ± 2.7 y) with excess weight. Blood pressure (BP), abdominal fat, carotid intima-media thickness (CIMT), and blood biochemistry were evaluated. Steatosis was assessed by the controlled attenuation parameter (CAP) obtained via transient elastography, and the participants were grouped as ¨Non-Steatosis¨ (n = 24) and ¨Steatosis¨ (n = 14).
RESULTS: The "Steatosis group" showed higher BP (Z SBP 1.56 vs. -0.25; Z DBP 1.38 vs. 0.07; p = 0.0001), BMI (z-BMI 3.48 vs. 2.39; p < 0.0001), right CIMT (0.07 vs. 0.06 cm; p = 0.013), basal insulin (41 vs. 14 mcUI/l; p < 0.0001), and HOMA-IR (8.2 vs. 3.1; p < 0.0001), and lower adiponectin (2.75 vs. 6.46 µg/ml; p = 0.004) compared to the "Non-Steatosis" group even after z-BMI adjustments. ROC curves indicated adiponectin (cutoff ≤ 4.5 μg/mL) and insulin (cutoff ≥ 22 mcIU/mL) as biomarkers of steatosis.
CONCLUSION: In pediatric age with excess weight, hepatic steatosis was associated with higher BP, severe obesity, and worse glycemic profile. Low adiponectin and high insulin levels appeared as possible biomarkers of MASLD. The study reinforces the need for children with obesity and a worse metabolic profile to be investigated for early diagnosis of MASLD.
PMID:41862169 | DOI:10.1016/j.jped.2026.101534