Dietary amino acids and the odds of metabolic dysfunction-associated fatty liver disease (MAFLD) among overweight and obese children and adolescents: A principal component analysis approach

Background Given the limited understanding of how dietary amino acid intake affects metabolic dysfunction-associated fatty liver disease (MAFLD), we examined the potential relationship between dietary amino acid patterns and the odds of MAFLD in children and adolescents with overweight and obesity. Methods This cross-sectional study was conducted on participants aged 6 to 18 years with a WHO body mass index (BMI)-for-age z-score ≥ 1. MAFLD diagnosis followed established consensus definitions. Principal component factor analyses were conducted based on eighteen amino acids. Logistic regression models, adjusted for potential confounders, were used to estimate the odds of MAFLD across amino acid pattern score quartiles. Results A total of 505 (52.9% boys) with mean ± SD age and BMI-for-age-Z-score of 10.0 ± 2.3 and 2.70 ± 1.01, respectively, were enrolled. Three major amino acid patterns were characterized: (1) higher loads by branched chain, lysine, tyrosine, threonine, methionine, histidine, alanine, and aspartic acid; (2) higher loads of proline, serine, glutamic acid, and phenylalanine; (3) higher loads of tryptophan, arginine, glycine, and cysteine. After adjusting for all potential confounders, participants in the highest quartile of the first amino acid pattern tended to be associated with increased odds of MAFLD (OR:2.14; 95%CI:0.97–4.77). There was no significant association for the second and third patterns. Conclusions These novel data suggest that the amino acid composition of an individual’s diet may modify their odds of MAFLD.