Nonalcoholic fatty liver disease (NAFLD) is a growing health problem in the pediatric population, due to the constantly increasing percentage of children with obesity. The objective of the study was to assess the occurrence of NAFLD based on ultrasound (USG) analysis and the use of alanine aminotransferase (ALT) in children with overweight and obesity depending on glucose tolerance. Medical records of 228 consecutive patients aged 2-18 years with overweight and obesity were reviewed retrospectively. Based on the oral glucose tolerance test children were divided into groups according to the severity of carbohydrate metabolism disorders. ALT, lipid parameters and insulin sensitivity indices HOMA, Matsuda and Quicki were analyzed. NAFLD was diagnosed (based on the USG) in 51 patients (23.61%) - the incidence in the impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) group was significantly higher when compared to ones without glucose intolerance. Because of extreme values of metabolic parameters in TDM2 children being outliers, they were not considered in the statistical analysis of the study. 22 (11.58%) patients had elevated ALT values, of which 12 (54.55%) had hepatic steatosis features on ultrasound. 72.73% (n=32) patients with fatty liver features on USG had ALT values considered normal with cut-off point 42 U/l accepted in this study. Almost every fourth obese child in the study group presents features of fatty liver in ultrasound examination. Although ultrasound is not recommended by North American Society For Pediatric Gastroenterology, Hepatology &Nutrition(NASPGHAN) for the diagnosis of NAFLD in children, it allows identifying a high percentage of children with features of fatty liver. This percentage increases significantly in children with glucose intolerance.

Background: Childhood obesity is a growing global health concern, with an increasing prevalence of severe obesity among young children. This study aimed to determine the average age of severe obesity onset in Polish children and evaluate the time gap between diagnosis and referral for specialized care. Methods: This data analysis was conducted across four Polish pediatric endocrinology centers specializing in childhood obesity management (Szczecin, Cracow, Zabrze, Rzeszów) between July 2022 and November 2023. The study included 367 children and adolescents (186 boys, 181 girls) aged 0–18 years, diagnosed with severe obesity based on age-specific BMI criteria. Anthropometric measurements were performed during the patient’s inclusion into the study and based on past medical records. BMI and BMI Z-scores were calculated for all current and past measurements. Results: The median age of the study population at the moment of inclusion into the study was 13.7 ± 2.9 years (range: 2.2–18 years). The median BMI was 40.9 ± 5.1 kg/m² (range: 30.1–65.8 kg/m²), and the median BMI Z-score was 2.7 ± 0.4 (range: 2.3–6.2). Out of the 367 children included, 327 (89%) had entered puberty. An analysis of past measurements revealed that 83% of children had severe obesity at their earliest recorded BMI measurement, with n median onset age of 3.2 years. The median age of referral to specialized care was 10 ± 5.0 years, reflecting a delay of almost 7 years from diagnosis to targeted medical care. Conclusions: This study highlights a substantial delay between the onset of severe obesity and referral for specialized care, underscoring the need for earlier intervention strategies tailored to age, sex, and developmental stage.

Background: The growing problem of excess body weight in children is currently one of the most important public health threats. Methods: The aim of this study was to assess the impact of a year-long intervention on the body composition and blood pressure of 6–10-year-old children with excess body weight in the city of Szczecin. This study was divided into two parts: stage I was a cross-sectional population-based study (screening in schools) while stage II was an interventional study with before/after comparison. Results: A total of 4890 children participated in the first stage, while 515 children qualified for the second stage. During each visit in the intervention stage, anthropometric measurement (height, body weight), body composition analysis using bioelectrical impedance (body fat mass in kilograms, percentage of body fat, muscle mass in kilograms, fat-free mass), and blood pressure measurement were performed. This study did not record a significant effect of the year-long intervention on changes in the blood pressure percentiles of the children. However, there was a significant increase in the number of children with a normal percentage of body fat (92.64% vs. 96.92%) and a significant increase in muscle mass in the majority of children (96.30%, p < 0.0001). The body fat percentage, body fat mass, and muscle mass measurements differed between children who were overweight and those who were obese. The average percentage (girls 27.80 ± 2.72 vs. 24.61 ± 3.04; p < 0.0001, boys 20.93 ± 4.51 vs. 16.02 ± 1.83; p < 0.0001) and mass of body fat (girls 12.12 ± 2.82 vs. 9.44 ± 1.46; p = 0.0001, boys 9.73 ± 3.72 vs. 6.16 ± 1.31; p = 0.0001), as well as the average muscle mass (31.01 ± 4.6 vs. 26.8 ± 4.08; p < 0.0001), were higher in children with obesity compared to those with overweight. Conclusions: Further research is necessary to evaluate the effectiveness of therapeutic programs focused on treating excess body weight in children.