[Metabolic Dysfunction-Associated Steatotic Liver Disease and its association with prediabetes in adolescents with obesity].

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a complication of obesity and insulin resistance that can lead to serious health implications. The fatty liver index (FLI) and ultrasound have gained relevance for their ability to predict MASLD. Objective: To analyze the association between MASLD using FLI and ultrasound with the presence of prediabetes in adolescents with obesity. Methods: Cross-sectional study. Pediatric patients of both sexes, aged 10 to 16 years, with obesity were included. Clinical data and anthropometric measurements were recorded, biochemical variables and FLI were determined, and liver ultrasound was performed using geographic mapping. Results: A total of 89 patients were analyzed, 46 (51.69%) were male; of the total, 27 (30.3 %) had prediabetes: 56 (62.9 %) had MASLD by FLI, and 62 (69.6 %) had MASLD by ultrasound. The FLI was 67.1 ± 20.3 and was positive in 74 % of adolescents with obesity and prediabetes. MASLD determined by ultrasound was associated with the presence of prediabetes, OR 3.39 (95%CI 1.04 - 11.04), p = 0.04. Conclusions: MASLD determined by ultrasound, was associated with the presence of prediabetes in adolescents with obesity. In pediatric patients, FLI requires further research to demonstrate its usefulness as a noninvasive complementary marker for the early identification of metabolic liver disorders in patients who also have prediabetes.