Interplay of childhood metabolic dysfunction-associated steatotic liver disease and obesity in the development of youth-onset type 2 diabetes

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart of the literature selection process. RCT: Randomized controlled trial.

Figure 2 Global and regional prevalence of childhood obesity and metabolic dysfunction-associated steatotic liver disease. MASLD: Metabolic dysfunction-associated steatotic liver disease.

Figure 3 Rising global trends in adolescent obesity and its contribution to the increasing prevalence of youth-onset type 2 diabetes. T2D: Type 2 diabetes; T2DM: Type 2 diabetes mellitus.

Figure 4 Pathophysiological mechanisms underlying metabolic dysfunction-associated steatotic liver disease and youth-onset type 2 diabetes in pediatric populations. BCAA: Branched-chain amino acid; DAG: Diacylglycerol; IKK: IκB kinase; IL-6: Interleukin-6; IRS: Insulin receptor substrate; JNK: C-Jun N-terminal kinase; LPS: Lipopolysaccharide; MASLD: Metabolic dysfunction-associated steatotic liver disease; MDA: Malondialdehyde; mTOR: Mechanistic target of rapamycin; PK: Protein kinase; ROS: Reactive oxygen species; TNF-α: Tumor necrosis factor-alpha.

Figure 5 Psychological factors influencing childhood metabolic dysfunction-associated steatotic liver disease, obesity, and youth-onset type 2 diabetes. T2D: Type 2 diabetes; MASLD: Metabolic dysfunction-associated steatotic liver disease; ADHD: Attention deficit hyperactivity disorder; ↓: Reduce.

Figure 6 Preventive strategies for pediatric metabolic dysfunction-associated steatotic liver disease and youth-onset type 2 diabetes. MASLD: Metabolic dysfunction-associated steatotic liver disease; T2D: Type 2 diabetes.