Affiliation:
1. Peking University School of Public Health
2. Ningbo City First Hospital
Abstract
Abstract
Aims & Background:
Currently, most predictions of metabolic associated fatty liver disease (MAFLD) in school-aged children utilize indicators that usually predict nonalcoholic fatty liver disease (NAFLD). The present study aimed to develop new predictive models and predictors for children with MAFLD, which could enhance the feasibility of MAFLD screening programs in the future.
Methods
A total of 331 school-aged obese/overweight children were recruited from six primary schools in Ningbo city, China. Hepatic steatosis and fibrosis were detected with controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively. Machine learning methods to build a set of variables to predict MAFLD in children. Then, the areas under the curve (AUC) of multiple models were compared to predict pediatric MAFLD.
Results
Compared with non-MAFLD children, children with MAFLD had more obvious metabolic abnormalities as they had higher anthropometric indicators, alanine aminotransferase, fasting plasma glucose, and higher inflammation indicators (white blood cell count, hemoglobin, neutrophil) (all P < 0.05). The optimal variables for total subjects calculated by random forest (RF) were alanine aminotransferase, uric acid, insulin and BMI. RF performed best among the four models constructed to predict MAFLD in children, with an AUC value of 0.703. LnAI-WHR, LnAI and LnAL-WHtR were satisfactory indices for predicting pediatric MAFLD in all participants, boys and girls individually.
Conclusions
This study developed a RF model and sex-specific indices for predicting MAFLD in overweight/obese children that may be useful for widespread screening and identification of children at high risk of MAFLD for early treatment.
Publisher
Research Square Platform LLC
Reference33 articles.
1. Manco M. Insulin Resistance and NAFLD: A Dangerous Liaison beyond the Genetics.Children-Basel. 2017;4(8).
2. Song K, Park G, Lee HS, Lee M, Lee HI, Ahn J et al. Trends in Prediabetes and Non-Alcoholic Fatty Liver Disease Associated with Abdominal Obesity among Korean Children and Adolescents: Based on the Korea National Health and Nutrition Examination Survey between 2009 and 2018.Biomedicines. 2022;10(3).
3. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis;Riazi K;Lancet Gastroenterol Hepatol,2022
4. Non-alcoholic fatty liver disease, obesity and the metabolic syndrome;Dietrich P;Best Pract Res Cl Ga,2014
5. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement;Eslam M;J Hepatol,2020