Value of elevated 1-hour post-load plasma glucose level in identifying risk of MAFLD in non-diabetic obese children and adolescents.

OBJECTIVE: To evaluate the potential value of 1-h post-load plasma glucose level in patients who are prone to suffer from metabolic associated fatty liver disease (MAFLD) in a group of non-diabetic obese children and adolescents. METHODS: Cardio-metabolic risk factors, oral glucose tolerance test outcomes, and Liver ultrasonic examination results were analyzed in 406 non-diabetic obese children and adolescents. Patients were divided into 4 groups: normal glucose tolerance with 1-h plasma glucose (NGT with 1-h PG) < 8.6 mmol/L, NGT with 1-h PG ≥ 8.6 mmol/L, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). RESULTS: In this study, 406 non-diabetic children and adolescents with obesity (249 males, 157 females, mean age: 11.71 ± 2.22 years) were included. Among them, 286 (70.4%) had NGT, 30 (7.4%) had IFG, and 90 (22.2%) had IGT. As compared with NGT with 1-h PG < 8.6 mmol/L, NGT with 1-h PG ≥ 8.6 mmol/L and IGT groups demonstrated significantly higher body fat percentage, obesity family history, triglycerides, gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST). After adjusting for age, sex, and BMI z-score, the 1-h PG level demonstrated significant positive correlations with ALT (Spearman's ρ = 0.12, P = 0.018), AST (ρ = 0.15, P = 0.003), and GGT (ρ = 0.21, P < 0.001). In the multivariable-adjusted logistic regression model controlling for age, sex, BMI z-score, body fat percentage, homeostatic model assessment of insulin resistance and glycosylated hemoglobin, individuals with NGT and 1-h PG ≥ 8.6 mmol/L exhibited 1.882-fold higher odds of MAFLD (95% CI 1.045-3.388), while the IGT group showed significantly elevated odds (OR = 1.980, 95% CI 1.056-3.709). No statistically significant association was observed in the IFG group. CONCLUSION: These data suggest that NGT with 1-h PG ≥ 8.6 mmol/L in non-diabetic obese pediatric patients can facilitate identifying individuals at higher risk of MAFLD.