ArticlePediatric investigation2026
Prevalence of non-alcoholic fatty liver disease and its association with different combinations of weight status and metabolic abnormalities in children aged 6-18 years.
Article in Pediatric investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Importance: Obesity and non-alcoholic fatty liver disease (NAFLD) guidelines recommend screening for NAFLD in children with obesity or overweight plus metabolic abnormalities. However, which metabolic factor is more closely associated with NAFLD in children with overweight or obesity remains unknown, and the risk of NAFLD in non-overweight children with metabolic abnormalities remains unclear. Objective: We aimed to explore the prevalence of NAFLD and its association with different combinations of weight status and metabolic abnormalities in children aged 6-18 years. Methods: Participants aged 6-18 years were recruited from the China Child and Adolescent NAFLD Study (CCANS). NAFLD was defined by ultrasonography or magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Metabolic abnormalities include hypertension, hyperglycemia, hyperuricemia, high triglycerides (TG), low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol. Multiple logistic regression models were used to assess the association of different combinations of weight statuses and metabolic abnormalities with NAFLD. Results: A total of 11 760 participants were included. The prevalence of NAFLD increased with increasing weight status (1.1%, 13.7%, and 39.8% among children with non-overweight, overweight, and obesity, respectively; Interpretation: Non-overweight children with metabolic abnormalities might have an increased risk of NAFLD. These findings suggest that overweight and obesity should not be the sole criteria for NAFLD screening in children. In particular, more attention should be given to screening for NAFLD in non-overweight children with metabolic abnormalities, as well as in overweight children.
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