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The external validation was performed using a cohort of children with overweight\/obesity (<jats:italic>N<\/jats:italic>\u00a0=\u00a046) aged 8.5\u201314.0\u2009years. MAFLD (\u22655.5% hepatic fat) was diagnosed by magnetic resonance imaging (MRI). Fasting blood biochemical parameters were measured, and 25 candidates\u2019 single nucleotide polymorphisms (SNPs) were determined. Variables potentially associated with the presence of MAFLD were included in a multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children with MAFLD (36%) showed higher plasma triglycerides (TG), insulin, homeostasis model assessment of insulin resistance (HOMA\u2010IR), alanine aminotransferase (ALT), aspartate transaminase (AST), glutamyl\u2010transferase (GGT) and ferritin (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The distribution of the risk\u2010alleles of <jats:italic>PPARGrs13081389<\/jats:italic>, <jats:italic>PPARGrs1801282<\/jats:italic>, <jats:italic>HFErs1800562<\/jats:italic> and <jats:italic>PNLPLA3rs4823173<\/jats:italic> was significantly different between children with and without MAFLD (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Three biochemical\u2010 and\/or SNPs\u2010based predictive models were developed, showing strong discriminatory capacity (AUC\u2010ROC: 0.708\u20130.888) but limited diagnostic performance (sensitivity 67%\u201382% and specificity 63%\u201369%). A prediction protocol with elevated sensitivity (72%) and specificity (84%) based on two consecutive steps was developed. The external validation showed similar results: sensitivity of 70% and specificity of 85%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The HEPAKID prediction protocol is an accurate, easy to implant, minimally invasive and low economic cost tool useful for the early identification and management of paediatric MAFLD in primary care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijpo.12917","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T11:57:27Z","timestamp":1649419047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Development of a prediction protocol for the screening of metabolic associated fatty liver disease in children with overweight or obesity"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-7583","authenticated-orcid":false,"given":"Maddi","family":"Oses","sequence":"first","affiliation":[{"name":"Institute for Sustainability &amp; Food Chain Innovation (ISFOOD) University of Navarra  Pamplona Spain"},{"name":"Navarra Institute for Health Research IdiSNA  Pamplona Spain"},{"name":"Department of Health Sciences Public University of Navarra, Campus de Arrosadia  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-9108","authenticated-orcid":false,"given":"Cristina","family":"Cadenas\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Institute for Sustainability &amp; Food Chain Innovation (ISFOOD) University of Navarra  Pamplona Spain"},{"name":"Navarra Institute for Health Research IdiSNA  Pamplona Spain"},{"name":"Department of Health Sciences Public University of Navarra, Campus de Arrosadia  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-642X","authenticated-orcid":false,"given":"Mar\u00eda","family":"Medrano","sequence":"additional","affiliation":[{"name":"Institute for Sustainability &amp; Food Chain Innovation (ISFOOD) University of Navarra  Pamplona Spain"},{"name":"Navarra Institute for Health Research IdiSNA  Pamplona Spain"},{"name":"Department of Health Sciences Public University of Navarra, Campus de Arrosadia  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-5418","authenticated-orcid":false,"given":"Arkaitz","family":"Galbete","sequence":"additional","affiliation":[{"name":"Navarrabiomed\u2010Hospital Complex of Navarra and Public University of Navarra IdisNA REDISSEC  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Miranda\u2010Ferrua","sequence":"additional","affiliation":[{"name":"Institute for Sustainability &amp; Food Chain Innovation (ISFOOD) University of Navarra  Pamplona Spain"},{"name":"Navarra Institute for Health Research IdiSNA  Pamplona Spain"},{"name":"Department of Health Sciences Public University of Navarra, Campus de Arrosadia  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonatan R.","family":"Ruiz","sequence":"additional","affiliation":[{"name":"PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, School of Sports Science University of Granada  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"S\u00e1nchez\u2010Valverde","sequence":"additional","affiliation":[{"name":"Gastroenterology and Paediatric Nutrition Unit Virgen del Camino Hospital  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco B.","family":"Ortega","sequence":"additional","affiliation":[{"name":"PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, School of Sports Science University of Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Cabeza","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronic and Communications Engineering, Institute of smart cities (ISC) Public University of Navarre  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-2530","authenticated-orcid":false,"given":"Arantxa","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research IdiSNA  Pamplona Spain"},{"name":"Department of Electrical, Electronic and Communications Engineering, Institute of smart cities (ISC) Public University of Navarre  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Idoate","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Public University of Navarra, Campus de Arrosadia  Pamplona Spain"},{"name":"Department of Radiology Mutua Navarra  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idoia","family":"Labayen","sequence":"additional","affiliation":[{"name":"Institute for Sustainability &amp; 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