Estimating Global Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease in Overweight or Obese Children and Adolescents: Systematic Review and Meta-Analysis.

Objectives

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new terminology updated from non-alcoholic fatty liver disease (NAFLD). We aim to estimate the global prevalence of MAFLD in overweight or obese children and adolescents, by repurposing existing data on fatty liver disease.

Methods

We screened relevant articles published up to December 2020. Pooled prevalence was calculated using Logit transformations.

Results

Our search returned 35,441 records, of which 156 studies fulfilled the inclusion criteria. The overall prevalence of MAFLD was 33.78% in the general population and 44.94% in a special population based on child obesity clinics, regardless of the diagnostic techniques. For subgroup analysis, MAFLD prevalence was significantly higher in boys compared to girls (36.05 vs. 26.84% in the general population; 50.20 vs. 35.34% in the child obesity clinics-based population). Interestingly, based on study source, the pooled prevalence of MAFLD was 1.5-fold higher in other "fatty liver disease" studies compared to the classical "NAFLD" studies in the general population.

Conclusion

MAFLD is highly prevalent in overweight or obese children and adolescents. Raising awareness and urgent actions are warranted to control the MAFLD pandemic across the globe.