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Anthropometric measurements, liver function tests, and metabolic marker analysis were conducted, and fibrosis scores were calculated. Transient elastography was performed in 69 some patients with nonalcoholic fatty liver disease. TaqMan allelic discrimination assays were used for genotyping. The genetic risk scores were calculated using significant variants, namely, <jats:italic>HSD17B13<\/jats:italic>, <jats:italic>PARVB<\/jats:italic>, <jats:italic>PNPLA3<\/jats:italic>, <jats:italic>SAMM50<\/jats:italic>, and <jats:italic>TM6SF2<\/jats:italic>, to evaluate the additive effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Risk allele carriers of the <jats:italic>PARVB<\/jats:italic> variant showed significantly higher levels of aminotransferases, gamma\u2010glutamyl transferase, alkaline phosphatase, pediatric nonalcoholic fatty liver disease fibrosis score, and aspartate aminotransferase\/platelet ratio index. Individuals with a homozygous variant of <jats:italic>HSD17B13<\/jats:italic> showed significantly lower levels of aminotransferase, gamma\u2010glutamyl transferase, liver stiffness measurement, and aspartate aminotransferase\/platelet ratio index than those with other genotypes. These parameters did not significantly differ among other variants of <jats:italic>LYPLAL1<\/jats:italic>, <jats:italic>GCKR<\/jats:italic>, <jats:italic>TRIB1<\/jats:italic>, <jats:italic>APOC3<\/jats:italic>, and <jats:italic>MBOAT7<\/jats:italic>. The genetic risk scores was identified as an independent risk factor for nonalcoholic fatty liver disease and had a positive association with severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>HSD17B13<\/jats:italic> has protective effects on the severity of pediatric nonalcoholic fatty liver disease. Variants of <jats:italic>HSD17B13<\/jats:italic>, <jats:italic>PARVB<\/jats:italic>, <jats:italic>PNPLA3<\/jats:italic>, <jats:italic>SAMM50<\/jats:italic>, and <jats:italic>TM6SF2<\/jats:italic> had an additive effect on nonalcoholic fatty liver disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16521","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T03:50:30Z","timestamp":1709178630000},"page":"1172-1182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<i>PARVB<\/i> and <i>HSD17B13<\/i> variants are associated with nonalcoholic fatty liver disease in children"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-384X","authenticated-orcid":false,"given":"Kyung Jae","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"},{"name":"Department of Pediatrics Hallym University Sacred Heart Hospital  Anyang Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-297X","authenticated-orcid":false,"given":"Jin Soo","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7017-3968","authenticated-orcid":false,"given":"Jin Gyu","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1160-1998","authenticated-orcid":false,"given":"Homin","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4463-4852","authenticated-orcid":false,"given":"Jeong Eun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-8242","authenticated-orcid":false,"given":"Lia","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Hallym Institute of Translational Genomics &amp; 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