{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:39:59Z","timestamp":1779331199214,"version":"3.51.4"},"reference-count":50,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T00:00:00Z","timestamp":1696636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FUNSALUD"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Metabolic-dysfunction-associated steatotic liver disease or MASLD is the main cause of chronic liver diseases in children, and it is estimated to affect 35% of children living with obesity. This study aimed to identify metabolic phenotypes associated with two advanced stages of MASLD (hepatic steatosis and hepatic steatosis plus fibrosis) in Mexican children with obesity. Materials and Methods: This is a cross-sectional analysis derived from a randomized clinical trial conducted in children and adolescents with obesity aged 8 to 16 years. Anthropometric and biochemical data were measured, and targeted metabolomic analyses were carried out using mass spectrometry. Liver steatosis and fibrosis were estimated using transient elastography (Fibroscan\u00ae Echosens, Paris, France). Three groups were studied: a non-MASLD group, an MASLD group, and a group for MASLD + fibrosis. A partial least squares discriminant analysis (PLS-DA) was performed to identify the discrimination between the study groups and to visualize the differences between their heatmaps; also, Variable Importance Projection (VIP) plots were graphed. A VIP score of &gt;1.5 was considered to establish the importance of metabolites and biochemical parameters that characterized each group. Logistic regression models were constructed considering VIP scores of &gt;1.5, and the receiver operating characteristic (ROC) curves were estimated to evaluate different combinations of variables. Results: The metabolic MASLD phenotype was associated with increased concentrations of ALT and decreased arginine, glycine, and acylcarnitine (AC) AC5:1, while MASLD + fibrosis, an advanced stage of MASLD, was associated with a phenotype characterized by increased concentrations of ALT, proline, and alanine and a decreased Matsuda Index. Conclusions: The metabolic MASLD phenotype changes as this metabolic dysfunction progresses. Understanding metabolic disturbances in MASLD would allow for early identification and the development of intervention strategies focused on limiting the progression of liver damage in children and adolescents.<\/jats:p>","DOI":"10.3390\/medicina59101785","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T14:17:26Z","timestamp":1696688246000},"page":"1785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Metabolomic Phenotype of Hepatic Steatosis and Fibrosis in Mexican Children Living with Obesity"],"prefix":"10.3390","volume":"59","author":[{"given":"Nayely","family":"Garibay-Nieto","sequence":"first","affiliation":[{"name":"Pediatric Obesity Clinic and Wellness Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Pedraza-Escudero","sequence":"additional","affiliation":[{"name":"Pediatric Obesity Clinic and Wellness Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0493-5140","authenticated-orcid":false,"given":"Isabel","family":"Oma\u00f1a-Guzm\u00e1n","sequence":"additional","affiliation":[{"name":"Pediatric Obesity Clinic and Wellness Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9832-9207","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Garc\u00e9s-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Pediatric Obesity Clinic and Wellness Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-8850","authenticated-orcid":false,"given":"Er\u00e9ndira","family":"Villanueva-Ortega","sequence":"additional","affiliation":[{"name":"Pediatric Obesity Clinic and Wellness Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1326-0402","authenticated-orcid":false,"given":"Mariana","family":"Flores-Torres","sequence":"additional","affiliation":[{"name":"Unidad de Vinculaci\u00f3n de la Facultad de Medicina, UNAM, Instituto Nacional de Medicina Gen\u00f3mica, Mexico City 14610, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4367-8463","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"P\u00e9rez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Hepatology Clinic, Gastroenterology Department, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2934-6091","authenticated-orcid":false,"given":"Mireya","family":"Le\u00f3n-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Research Unit, General Hospital of Mexico, Mexico City 06720, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3271-9955","authenticated-orcid":false,"given":"Estibalitz","family":"Laresgoiti-Servitje","sequence":"additional","affiliation":[{"name":"Clinical Health Sciences, School of Medicine and Health Sciences, Tecnol\u00f3gico de Monterrey, Monterrey 64849, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berenice","family":"Palacios-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Laboratorio de Envejecimiento Saludable, Centro de Investigaci\u00f3n Sobre el Envejecimiento, Instituto Nacional de Medicina Gen\u00f3mica, Mexico City 14610, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0966-8766","authenticated-orcid":false,"given":"Juan Carlos","family":"L\u00f3pez-Alvarenga","sequence":"additional","affiliation":[{"name":"Department of Population Health & Biostatistics, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7929-6841","authenticated-orcid":false,"given":"Mauricio","family":"Lisker-Melman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Vadillo-Ortega","sequence":"additional","affiliation":[{"name":"Unidad de Vinculaci\u00f3n de la Facultad de Medicina, UNAM, Instituto Nacional de Medicina Gen\u00f3mica, Mexico City 14610, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rinella, M.E., Lazarus, J.V., Ratziu, V., Francque, S.M., Sanyal, A.J., Kanwal, F., Romero, D., Abdelmalek, M.F., Anstee, Q.M., and Arab, J.P. 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