Endocrine Abstracts

JOINT3436

Introduction: Metabolic-associated steatotic liver disease (MASLD) is increasingly recognized in obese children and has been linked to early cardiovascular dysfunction. Arterial stiffness, a marker of subclinical atherosclerosis, may serve as an early indicator of cardiovascular risk in this population. This preliminary study explores the relationship between MASLD and arterial stiffness in obese children, aiming to assess potential cardiometabolic implications.

Methods: The study included 50 children aged 6 to 18, divided into two groups: 30 children with obesity (class 2 and 3) and 20 normal-weight controls. Assessments included BMI, waist circumference, waist-to-height ratio, and puberty stage. Arterial stiffness was evaluated using pulse wave velocity (PWV) via a Mobil-O-Graph single-point (brachial) oscillometer. Liver stiffness was assessed by shear-wave elastography (SWE, kPa and m/s) using a Mindray Resona R9 ultrasound system. Serum levels of fasting glucose, insulin, uric acid, lipid profile, triglycerides, transaminases, and 25-OH vitamin D were analyzed, along with HOMA-IR.

Results: Obese children had significantly higher SWE values than normal-weight peers (12.8 kPa vs. 7.31 kPa, p < 0.001). PWV was also significantly higher in the obese group (5.1 m/s vs. 4.5 m/s, P = 0.01). SWE and PWV correlated positively with BMI, waist circumference, and waist-to-height ratio, with PWV emerging as a significant independent predictor of these markers. Additionally, SWE and PWV were significantly correlated (ρ = 0.41, P = 0.03), with SWE remaining a predictor of PWV even after adjusting for BMI, waist circumference, and puberty stage. Both SWE and PWV correlated significantly with BP values (ρ = 0.58, P = 0.002). Regarding biochemical markers, PWV correlated positively with HOMA-IR and uric acid, while SWE correlated with HOMA-IR, triglycerides, LDL-c, and transaminases. Although 25-OH vitamin D was significantly lower in the obese group, no significant correlation was found with SWE or PWV.

Conclusion: Obese children show increased arterial and liver stiffness, suggesting an early link between MASLD and cardiovascular dysfunction. The correlation between SWE and PWV, independent of BMI, indicates that liver stiffness may contribute to vascular impairment beyond obesity alone. Associations with HOMA-IR, uric acid, and lipid markers further highlight the role of metabolic dysregulation. These findings emphasize the need for early hepatic and cardiovascular assessments in obese children to identify those at higher risk for future cardiometabolic complications.