ESPE Abstracts

Introduction: The prevalence of obesity constantly increases worldwide and definitely increases the risk of premature death in early adulthood. Metabolic dysfunction-associated fatty liver disease (MAFLD) – a new term for fatty liver disease accompanied by other components of metabolic syndrome (MetS) connected with increase cardiovascular risk either in adult or children. Whereas there is no yet treatment with proven efficacy for the metabolic clamp such as arterial hypertension (AH), insulin resistance, dyslipidemia, diabetes type 2, and MAFLD, it is imperative to find a way to decrease cardiometabolic complications. Early prevention strategies beginning in childhood are the most logical step to reduce premature cardiovascular morbidity and mortality in youth. Therefore, the current study is aimed to determine the most sensitive and specific predictive markers of the MAFLD with high cardiometabolic risk in overweight/obese adolescent boys.

Methods: This study involved 180 adolescent overweight or obese boys [median age was 16.0 (15.0-16.1) years] randomly chosen in rural and urban patients in Ternopil (Western Ukraine). A control group of 30 healthy children with proportional body weight comparable in gender and age to the main group was presented. A list of anthropometrical markers with biochemical values of carbohydrate and lipid metabolism with hepatic enzymes was determined. In the general cohort, 81.5 % were obese, 83.8 % have abdominal obesity, 63.0% - AH, 4.6 % - prediabetes, 26.4 % have hypertriglyceridemia, and 34.7 % have a pathologically low level of HDL-c. In addition, in 38.6% of overweight and obese subjects, ALAT was increased above >25 U/L. All overweight/obese boys were divided into two groups: 72.2 % of boys with MetS by IDF criteria, 27.8 % metabolically healthy obese (MHO) boys without AH, hyperglycemia and dyslipidemia. Boys who have only one criterion (AH, dyslipidemia or hyperglycemia) were exclude from the study.

Results: Based on multiple logistic regression analysis which included all anthropometric, biochemical values and calculated indexes in boys, it was detected that the maximum likelihood in the prediction of MetS makes Triglyceride glucose index, Triglyceride to high-density lipoprotein cholesterol ratio and pediatric NAFLD fibrosis index (PNFI) (R2 =0.721, P<0.000). Tracing the Receiver operating characteristics curve, the model is confirmed as a good predictor of MAFLD (AUC=0.887, Odds ratio=26,124 perc. correct=86.07%) in overweight and obese boys.

Conclusions: Triglyceride glucose index, Triglyceride to high-density lipoprotein cholesterol ratio and pediatric NAFLD fibrosis index is a valuable combination of criteria to detect MAFLD in overweight/obese boys.