Abstract: Objective The aim of this study was to investigate the change of anterior liver fat thickness (ALFT) and waist circumference (WC) in children with metabolic syndrome (MS). Methods The clinical data of 445 children undergoing physical examination in our hospital between February 2017 and February 2019 were analyzed retrospectively. Out of them, 54 children had non-alcoholic fatty liver disease (NAFLD) and 18 had MS. Another 54 children out of 373 healthy children were selected by age- and gender-matching for control. The ALFT, intra-abdominal fat thickness (IAFT), WC and the intima-media thickness (IMT) of carotid artery were measured by sonography, and serum parameter were also assayed. Results The ALFT, IAFT, WC in children with MS were(1.6±0.2)cm,(4.4±1.5)cm and (83.4±4.8)cm, significantly higher than【(1.3±0.4)cm,(3.4±1.5)cm and (76.8±5.3)cm, respectively, P<0.05】 in healthy or 【(1.4±0.3)cm,(3.5±1.6)cm and (80.3±5.0)cm, P < 0.05】 in children with NAFLD; the homeostasis model assessment of insulin resistance, serum high-sensitivity C-reactive protein level, systolic blood pressure and serum low density lipoprotein cholesterol level in children with MS were(5.9±1.6), (1.8±0.2)mg/L, (136.5±14.0)mmHg and (2.6±0.8)mmol/L, significantly greater than 【(3.5±1.7), (1.4±0.2) mg/L, (110.8±12.7)mmHg and (1.7±0.5)mmol/L, respectively, P < 0.05】 in healthy children or 【(4.2±1.5),(1.5±0.3)mg/L,(128.9±13.8)mmHg and (2.4±0.7)mmol/L, respectively,P < 0.05】 in children with NAFLD, while serum high density lipoprotein cholesterol level was(1.3±0.5) mmol/L, much lower than 【(1.8±0.7)mmol/L,P < 0.05】 in healthy children or 【1.4±0.5)mmol/L, P < 0.05】 in children with NAFLD; the multivariate Logistic analysis showed that ALFT (95% CI =1.098-4.198, OR=2.147, P=0.026), WC(95% CI =1.395-4.523, OR =2.512, P=0.002) and IAFT (95% CI =1.332-5.958, OR =2.817, P=0.007) were the independent risk factors for occurrence of MS in children. Conclusion The detection of ALFT by sonography is simple and easy to do, which might help to determine the presence of MS in children with NAFLD.

Key words: Metabolic syndrome, Non-alcoholic fatty liver disease, Anterior liver fat thickness, Waist circumference, Diagnosis