{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:01:22Z","timestamp":1780549282595,"version":"3.54.1"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: The presence of metabolic syndrome (MetS) in children predisposes them to steatotic liver disease, with or without liver enzyme alterations. Early diagnosis of the degree of liver damage can stop the progression to more severe dysfunction. Objectives: This study aimed to establish the link between liver enzyme levels and triglyceride and cholesterol values in pediatric patients with obesity, grouped according to MetS status and metabolic dysfunction-associated fatty liver disease (MAFLD). Methods: The retrospective observational study included 261 pediatric patients aged between 0 and 18 years diagnosed with obesity, MetS, and MAFLD. Before initiating the study, approval was obtained from the hospital\u2019s Ethics Committee. The clinical and biochemical data were collected from the patients\u2019 histories. Results: Alanine aminotransferase showed a significant positive correlation with triglyceride levels in the overall cohort, which became stronger in children with MetS and was strongest in those with ultrasonographically confirmed MAFLD. Similarly, aspartate aminotransferase demonstrated a weak positive correlation with triglycerides in the overall population, which increased in patients with MetS and became strong in children with MAFLD. Conclusions: In children with MetS and ultrasound-diagnosed MAFLD, liver enzymes showed progressively stronger positive correlations with triglyceride levels, indicating a close link between dyslipidemia and liver damage. Associations between liver enzymes and total cholesterol further support metabolic dysregulation, rather than body mass index alone, as a key driver of pediatric steatotic liver disease and highlight the value of targeted liver enzyme assessment in children with MetS or hypertriglyceridemia.<\/jats:p>","DOI":"10.3390\/metabo16030171","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T10:31:14Z","timestamp":1772706674000},"page":"171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Liver Injury Biomarkers in Pediatric Metabolic Syndrome: Key Biochemical Associations"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1599-5579","authenticated-orcid":false,"given":"Teofana-Otilia","family":"Bizerea-Moga","sequence":"first","affiliation":[{"name":"Department XI of Pediatrics-1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, \u2018Victor Babe\u0219\u2019 University of Medicine and Pharmacy Timi\u0219oara, Eftimie Murgu Sq No. 2, 300041 Timi\u0219oara, Romania"},{"name":"3rd Pediatric Clinic, \u2018Louis \u021aurcanu\u2019 Children\u2019s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-1856","authenticated-orcid":false,"given":"Tudor Voicu","family":"Moga","sequence":"additional","affiliation":[{"name":"Department VII of Internal Medicine-Gastroenterology Discipline, Advanced Regional Research Center in Gastroenterology and Hepatology, \u2018Victor Babe\u0219\u2019 University of Medicine and Pharmacy Timi\u0219oara, Eftimie Murgu Sq No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Gastroenterology and Hepatology Clinic, \u2018Pius Br\u00eenzeu\u2019 County Emergency Clinical Hospital, Liviu Rebreanu 156, 300723 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Panic Zaric","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mother and Child Health Care Institute of Serbia \u201cDr Vukan Cupic\u201d, 11070 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1592-4105","authenticated-orcid":false,"given":"Rade","family":"Vukovic","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mother and Child Health Care Institute of Serbia \u201cDr Vukan Cupic\u201d, 11070 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2313-7643","authenticated-orcid":false,"given":"Otilia","family":"M\u0103rginean","sequence":"additional","affiliation":[{"name":"Department XI of Pediatrics-1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, \u2018Victor Babe\u0219\u2019 University of Medicine and Pharmacy Timi\u0219oara, Eftimie Murgu Sq No. 2, 300041 Timi\u0219oara, Romania"},{"name":"3rd Pediatric Clinic, \u2018Louis \u021aurcanu\u2019 Children\u2019s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-1945","authenticated-orcid":false,"given":"Laz\u0103r","family":"Chi\u0219avu","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Faculty of Medicine, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Nephrology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1542\/peds.2006-1212","article-title":"Prevalence of fatty liver in children and adolescents","volume":"118","author":"Schwimmer","year":"2006","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s12519-024-00814-1","article-title":"Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents: A systematic review and meta-analysis","volume":"20","author":"Lee","year":"2024","journal-title":"World J. 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