Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease in School-Age Children and Adolescents in Shenyang, China

Abstract Background: Metabolic-associated fatty liver disease (MAFLD) refers to abnormal accumulation of fat in the liver for metabolic dysfunction. With modern socioeconomic conditions and changes in dietary patterns, the prevalence of MAFLD is increasing, to the detrimental of children’s learning and quality of life. We investigated the prevalence and influencing factors of metabolic-associated fatty liver disease (MAFLD) in school-aged children and adolescents in Shenyang, China. Methods: In 2019, we collected demographic, anthropometric and liver health assessments from a random sample of Shenyang’ s school-aged children (7-12 years old) and adolescents (13-18 years old). Experienced hepatologists used transient elastography to diagnose the presence of fatty liver in the students. A random subsample was selected to complete a questionnaire to explore the impact of lifestyle habits on fatty liver disease.Results: The overall prevalence of MAFLD in these students was 23.83%, with a non-significant difference between children (22.73%) and adolescents (24.43%). The prevalence of MAFLD was significantly higher among boys than among girls. Compared with non-overweight students, a significantly higher proportion of the overweight group had fatty liver. Moreover, questionnaire responses on exercise habits, normal diet, and parental factors were associated with fatty liver.Conclusions: MAFLD is very prevalent in children and adolescents in Shenyang city. Due to the close relationship between MAFLD and obesity, lifestyle plays a major role in the occurrence of MAFLD.Trial registration: the First Affiliated Hospital of China Medical University, [2020]2020-258-2. Registered 6 June 2020 - Retrospectively registered.