Children's experience of screening and evaluation for MASLD in overweight and obesity

OBJECTIVE: This study evaluates self-reported discomfort in children undergoing screening and evaluation for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) that includes blood sampling and vibration-controlled transient elastography (VCTE) or shear-wave elastography (SWE).

METHODS: In this cross-sectional multicenter cohort study, children with overweight or obesity, referred for MASLD evaluation after elevated ALT, were included. Children subsequently underwent anthropometric measurements, blood sampling, VCTE, and SWE during an outpatient visit. Discomfort was assessed using the validated "Discomfort in Research with Children" (DISCO-RC) questionnaire on a 5-point Likert scale.

RESULTS: 118 children (mean age 13 years) were included. Discomfort related to MASLD screening was low, with median domain scores of 1-2 before the MASLD evaluation visit and 1 after. Prior to the visit, 76-82 % reported "no" to "slight" discomfort (score 1-2) across domains; during the visit, this was 91-95 %. Median procedural discomfort per domain was 1 for both VCTE and SWE, though cumulative discomfort (6 domains) was greater for VCTE than SWE (8 [IQR 6,9] versus 7 [IQR 6,8] p < 0.001).

CONCLUSIONS: Screening and subsequent evaluation for MASLD, including VCTE or SWE for liver fibrosis assessment, is associated with minimal discomfort and is highly acceptable to children, supporting this screening strategy in pediatric clinical practice.