Chest Circumference Predicts MAFLD Better than Waist Circumference and BMI in Obese Prepubertal Children Aged 8 Years

Abstract Backgroundand Aim Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a new inclusive definition of the entire spectrum of liver diseases associated with metabolic disorders. This study aimed to determine the prevalence of MAFLD using controlled attenuation parameter (CAP) values obtained by transient elastography (TE) technique and identify the optimal predicator for diagnosing MAFLD in this population. Methods This study enrolled children who were part of the Shanghai Birth Cohort Study and had completed the 8-year-old follow-up. Anthropometric measurements were taken, and FibroScan-502 examination with an M probe (Echosens, Paris, France) was conducted on these children. The diagnosis of MAFLD was based on the median CAP exceeding 248 dB/m and predefined criteria. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal predicator for MAFLD in these children. Results A total of 848 healthy 8-year-old children (431 boys and 417 girls) who participated in the Shanghai Birth Cohort Study were included in the analysis. Among them, 113 (13.33%) children were classified as obese. The prevalence of obesity was significantly higher in boys (17.63%) than in girls (8.87%) ( p < 0.001). The prevalence of central obesity was significantly higher in girls (34.05%) than in boys (22.04%) ( p < 0.001). MAFLD was diagnosed in 29 (3.42%) children. The prevalence of MAFLD was significantly higher in the obese group (15.93%) than in the non-obese group (1.50%) ( p < 0.05). Children with MAFLD had significantly higher weight, BMI, chest circumference, waist circumference, hip circumference, waist-to-height ratio, waist-to-hip ratio, and liver stiffness measurement than non-MAFLD (all p < 0.05). Waist circumference (OR: 1.187; 95%CI: 1.132-1.243; p < 0.001) was significantly associated with the presence of MAFLD in these participants in multivariate linear regression analyses. Chest circumference (OR: 1.321; 95%CI: 1.123-1.424; p < 0.001) was significantly associated with the presence of MAFLD in obese participants and had the largest AUC of 0.813 in ROC curve analysis. Conclusion This study highlights the prevalence of MAFLD in prepubertal children, particularly in the obese subgroup. Our findings also suggest that chest circumference is an optimal anthropometric predicator for MAFLD in 8-year-old obese children.