• Isabel Omaña-Guzmán, Marisol Rosas-Diaz, Yoscelina Estrella Martínez-López, L Monserrat Perez-Navarro, Alvaro Diaz-Badillo, Anthony Alanis, Alejandra Bustamante, Octelina Castillo-Ruiz, Noemi Del Toro-Cisneros, Diego Armando Esquivel-Hernandez, Gloria Garcia-Villalobos, Nayely Garibay-Nieto, Esperanza Milagros Garcia-Oropesa, Juan Carlos Hernandez-Martinez, Elena Beatriz Lopez-Sosa, Carlos Maldonado, David Martinez, Joshua Membreno, Oscar Omar Moctezuma-Chavez, Claudia X Munguia-Cisneros, Edna J Nava-González, Adriana L Perales-Torres, Adolfo Pérez-García, Hector Rivera-Marrero, Alisha Valdez, Alfonso Alejandro Vázquez-Chávez, Carlos Ramirez-Pfeiffer, Kathleen V Carter, Beatriz Tapia, Leonel Vela, and Juan Carlos Lopez-Alvarenga.
• Pediatric Obesity Clinic and Wellness Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico.
• Bmc Med. 2024 Nov 21; 22 (1): 548548.

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a prevalent hepatic condition linked to metabolic alterations. It gradually causes liver damage and potentially progresses to cirrhosis. Despite its significance, research, especially in the pediatric population, is limited, leading to contradictory findings in diagnosis and treatment. This meta-analysis aims to synthesize existing literature on therapeutic interventions for MASLD in children and adolescents.MethodsA comprehensive search of randomized controlled clinical trials yielded 634 entries from PubMed, Scopus, and Web of Science up to 2023. Interventions included medications, behavioral modifications, dietary changes, probiotics, supplements, surgical procedures, or combinations. The analysis focused on studies with treatment duration of at least 3 months, employing a random-effects REML meta-analysis model. Treatment effects on anthropometric measurements and biochemical components were examined and adjusted for heterogeneity factors analysis. A bibliometric analysis for insights into research contributors was performed.ResultsThe systematic review incorporated 31 clinical trials, with 24 meeting criteria for meta-analysis. These comprised 3 medication studies, 20 with supplements, 4 focusing on lifestyle, and 4 centered on diets. Significant overall treatment effects were observed for ALT, AST, BMI, and HOMA-IR mainly by supplements and lifestyle. Meta-regression identified age, BMI changes, and treatment duration as factors modifying ALT concentrations. Bibliometric analysis involving 31 linked studies highlighted contributions from 13 countries, with the USA, Spain, and Chile being the most influential.ConclusionsWe conclude that supplementation and lifestyle changes can effectively impact ALT and AST levels, which can help address liver issues in obese children. However, the evaluation of risk bias, the high heterogeneity, and the bibliometric analysis emphasize the need for more high-quality studies and broader inclusion of diverse child populations to provide better therapeutic recommendations.Trial RegistrationPROSPERO, CRD42023393952. Registered on January 25, 2023.© 2024. The Author(s).

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