The correlation of apolipoprotein B and apolipoprotein A1 with metabolic dysfunction‐associated steatotic liver disease in children and adolescents with obesity

Summary Background Metabolic dysfunction‐associated steatotic liver disease (MASLD) has become a prevalent liver condition in children and teenagers with obesity. Unfortunately, there is no standardized treatment. Objective To examine the connection between apolipoprotein B (apoB), apolipoprotein A1 (apoA1), and the apoB/apoA1 ratio with the occurrence of MASLD in this population. Methods A retrospective study was made on children and adolescents with obesity in a children's hospital between the period 2020 and 2022. Anthropometric data, ultrasound results, and blood biochemistry were analysed to assess the connection between apoB, apoA1, and the presence of MASLD. Results Of the 916 participants included, 313 were diagnosed with MASLD. The level of serum apoB reflected a substantial dose–response correlation with the odds of having MASLD. When apoB levels exceeded the 50th percentile, the risk increased significantly, and at the 95th percentile, the odds were 4.83 times higher than at the 50th percentile (95% CI: 2.02–11.56). The ratio of apoB/apoA1 at the 95th percentile was connected to a 2.41‐fold higher prevalence compared to the 50th percentile (95% CI: 1.33–4.37). No significant correlation was found between the levels of apoA1 and MASLD prevalence. Conclusion Elevated levels of apoB and the apoB/apoA1 ratio have been strongly connected to increased MASLD prevalence in children and adolescents with obesity; hence, signifying their potential usefulness as biomarkers for early detection and intervention.