ArticleFrontiers in nutrition2026
Metabolic features in plasma and urine of obese children and their association with MAFLD risk.
Article in Frontiers in nutrition, 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
Objective: This study aimed to identify metabolic features in obese children that are associated with metabolic dysfunction-associated fatty liver disease (MAFLD), to explore the dose-response relationship between these metabolites and MAFLD, and to identify any differences depending on sex of the child. Methods: Obese children recruited from the outpatient clinic were categorized into obese with MAFLD (OB-MAFLD) and obese without MAFLD (OB-CON) groups via B-ultrasound. Anthropometric and laboratory examinations were conducted. Metabolomic analysis was performed using liquid chromatography-tandem mass spectrometry. Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were employed to identify differential metabolites. Logistic regression models were utilized to evaluate the associations between these metabolites and MAFLD risk, with gender-stratified analyses performed. Restricted cubic spline (RCS) regressions were applied to explore the dose-response relationship between these metabolites and MAFLD. Results: A total of 160 obese children aged 7-14 years were included, among whom 125 were assigned to the OB-MAFLD group and 35 to the OB-CON group. Four differential metabolites were identified: alanine and proline in plasma and hippuric acid and palmitic acid in urine. Alanine and proline were independent risk factors for the development of MAFLD in obese children, while hippuric acid and palmitic acid were protective factors against MAFLD. After stratification by sex, alanine was specifically associated with MAFLD in obese boys, palmitic acid with MAFLD in obese girls, and hippuric acid with MAFLD in both sexes; in contrast, proline showed no significant association with either group. RCS analysis showed that the associations between MAFLD and all four metabolites followed linear patterns (all Conclusion: Plasma and urinary metabolite alterations in obese children may confer either susceptibility to or protection against MAFLD development, with distinct sex-specific patterns. These metabolites may serve as quantitative biomarkers and therapeutic targets, advancing precision intervention strategies for obesity-associated MAFLD.
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