Abstract: Objective To analyze the relevant indicators in children with simple obesity and explore the high-risk factors associated with the development of metabolism-related fatty liver disease (MAFLD), with the ultimate goal of providing valuable insights for children's healthcare. Methods A total of 140 children with simple obesity were included in the study and categorized into either MAFLD group (n=52) or non-MAFLD group (n=88) based on the presence or absence of MAFLD. Baseline data and clinical indicators of the subjects were meticulously examined and recorded. The predictive value of MAFLD risk factors was evaluated through receiver operating characteristic curve (ROC) analysis in children with simple obese, both through univariate and Logistic multiple factors. Results Among the 140 children with simple obesity, a total of 52 cases were diagnosed with MAFLD, resulting in a prevalence rate of 37.12%. In the MAFLD group, the proportion of males, body mass index (BMI), lipid storage index (LAP), alanine aminotransferase (ALT), alkaline phosphatase (ALP), triglyceride (TG), uric acid (UA) and ferritin (SF) were noted as 71.54%, 27.46 kg/m², 37.98±6.35, 68 U/L, 5 6 U/L, 1.08 mmol/L, 423.58±27.36 μmol/L, 124.95±13.46 ng/mL, respectively. On the other hand, in the non-MAFLD group, these values were 52.27%, 25.19 kg/m², 46.82±7.04, 29 U/L, 47 U/L, 0.81 mmol/L, 346.75±21.08 μmol/L, 95.38±7.45 ng/mL. The differences between the two groups were statistically significant (t/χ²/Z=3.517, 6.254, 8.472, 9.596, 6.528, 5.329, 9.427, 9.781, all P<0.05). Logistic regression analysis indicated that LAP, ALT, UA and SF were independent influencing factors for MAFLD in children with simple obesity (95% CI: 1.047-1.092, 1.012-1.157, 1.020-1.059, 1.017-1.063, 95% CI was 1.047-1.092, 1.012-1.157, 1.020-1.059, 1.017-1.063, OR=1.063, 1.084, 1.035, 1.049, all P<0.05). Additionally, ROC analysis showed that the area under the curve (AUC) of LAP, ALT, UA and SF were 0.741, 0.849, 0.783 and 0.682, respectively, with corresponding sensitivities of 86.27%, 81.35%, 72.86% and 87.94%, and specificities of 73.85%, 91.27%, 78.13%, 70.36%. Conclusion Elevations in LAP, ALT, UA and SF are identified as independent influencing factors for MAFLD in children with simple obesity. These findings suggest that these parameters can serve as non-invasive predicators for the early identification, diagnosis and evaluation of MAFLD in this population.

Key words: Simple obesity, MAFLD, Risk factors, Child health