Metabolic Dysfunction–Associated Steatotic Liver Disease Among Children and Adolescents in a Tertiary Centre in Sarawak
https://doi.org/10.15605/jafes.041.S1
- Author:
Geraldine Yee Pei Lim
1
;
Victoria David
1
;
Kiew Siong Lau
2
;
Chiong Hung Kiew
3
;
Hooi Peng Cheng
3
Author Information
1. Nursing Unit, Sarawak General Hospital
2. Department of Radiology, Sarawak General Hospital
3. Department of Paediatrics, Sarawak General Hospital
- Publication Type:Journal Article
- MeSH:
Adolescent;
Child;
Malaysia;
Liver Diseases
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):131-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:The global rise in paediatric obesity has led to an increasing burden of metabolic comorbidities, including metabolic
dysfunction–associated steatotic liver disease (MASLD). Obstructive sleep apnea (OSA), characterized by chronic
intermittent hypoxia, has been implicated in the pathogenesis of liver injury. This study aimed to evaluate the prevalence
of MASLD and its association with OSA among children and adolescents in a tertiary centre.
Methodology:A retrospective cross-sectional study was conducted involving children aged 6–15 years who were admitted for
polysomnography at Sarawak General Hospital between 2024 and 2025. Clinical, biochemical, and lifestyle data were
obtained from medical records and parental questionnaires. Hepatic steatosis was assessed using hepatobiliary ultrasound
in a subset of patients.
Results:A total of 132 children (mean age 10.8 ± 2.7 years; 87.5% male) were included. The median BMI SDS was 2.50 (IQR: 2.29–
2.93). The mean apnea–hypopnea index (AHI) was 12.0 ± 7.9, with 60% classified as severe OSA.
Among the 16 children who underwent liver ultrasound, MASLD was identified in 81.2%, including five cases of grade
1 and eight cases of grade 2 steatosis. Liver transaminitis was present in six patients. Metabolic comorbidities were
common, with 43.8% requiring metformin for insulin resistance or impaired glucose tolerance, and four patients requiring
antihypertensive therapy.
Unhealthy lifestyle behaviors were prevalent: 64.2% consumed sugary drinks ≥3 times weekly, 42.9% consumed fast food
≥3 times weekly, and only 24.3% reported daily fruit or vegetable intake. Physical inactivity (≤2 times/week) was observed
in 71.4%, while 64.3% had screen time exceeding 2 hours daily.
Conclusion:Children and adolescents with moderate-to-severe OSA exhibit a high burden of metabolic dysfunction, including MASLD.
The findings support a potential contributory role of OSA-related hypoxia in paediatric fatty liver disease and highlight
the need for integrated screening and early intervention in this high-risk population.
- Full text:2026080510481286268BP_P004.pdf
