Clinical and Biochemical Predictors of Non-Alcoholic Fatty Liver Disease in Obese Children and Adolescents

Background: Obesity and its associated comorbidities are growing worldwide, including nonalcoholic fatty liver disease (NAFLD), which is one of the leading causes of chronic liver diseases in both children and adults. The aim of this study was to determine the prevalence of NAFLD among obese children and to investigate the clinical and biochemical predictors associated with NAFLD. Methods: Ninety obese children and adolescents aged 12-18 years were enrolled in this study. All participants underwent anthropometric measurements and biochemical analyses including fasting blood glucose, serum insulin, serum triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and liver function tests. Ultrasonography was used to diagnose NAFLD. Results: The prevalence of NAFLD was 38.9% among obese children, 68.6% of whom met the criteria for metabolic syndrome. Children with NAFLD had significantly higher body mass index, waist circumference, ALT, total cholesterol, LDL-c, TG, fasting insulin, and lower HDL-c levels than those with normal liver ultrasound (P< 0.05). Insulin resistance was significantly more common in the NAFLD group (88.6% vs. 18.2%) (P<001). Logistic regression analysis revealed that BMI and HOMA-IR were independent predictors of NAFLD (P = 0.034 and 0.022, respectively). Conclusion: More than one-third of obese children have NAFLD. which is closely linked to metabolic syndrome and insulin resistance.