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Life sciences · Journal article
International Journal of Child Health and Nutrition · October 9, 2026
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Purpose: Hepatic steatosis is a common hepatic comorbidity in children with overweight or obesity. Concurrent chronic liver diseases that may mimic or coexist with steatosis should be searched for properly to provide timely management. We aimed to screen a group of Egyptian children with obesity or overweight who were suspected of having Metabolically-dysfunction-associated steatotic liver disease (MASLD) for underlying causes of hepatic dysfunction using non-invasive tests. Methods: This cross-sectional study was conducted on 77 children who were overweight or obese, presenting with elevated alanine aminotransferase (ALT) for more than 3 months or bright liver on imaging or both. All children underwent a comprehensive history and clinical examination, as well as liver function tests, lipid profile, HbA1c testing, screening tests for known chronic liver diseases, and an abdominal ultrasound. Results: 66.3% of participants were obese, and 33.7% were overweight, with a mean age of 10.4±3.4 years, and an almost equal gender distribution. All participants had a bright hepatic echo pattern, and 40.3% had elevated ALT levels. Three patients (3.8%) had positive results: one with WD, one with chronic hepatitis C, and one with chronic hepatitis B. None of the participants met the diagnostic criteria for celiac disease, alpha-1 antitrypsin deficiency, autoimmune hepatitis, or thyroid dysfunction. Conclusion: Among our studied children with obesity or overweight who were referred with persistently elevated ALT, bright liver or both, and suspected to have MASLD, 3.8% had positive screening for chronic liver disease using non-invasive tests.