Table 1.

Diagnostic criteria of MAFLD and the application in the current study.

	Expert panel definitions	Application in current study
1st Criterion—Hepatic steatosis
Evidence of hepatic steatosis	An estimated ≥5% liver fat fraction, based on outcome of a liver biopsy, imaging (MRI or echo) or blood biomarkers.	Applied 2 different cut-offs: -≥2% liver fat fraction estimated from MRI scans. -≥5% liver fat fraction estimated from MRI scans.
2nd Criterion—Metabolic risk factor (at least one)
Excess adiposity	Either: -a BMI ≥1 SD of the WHO growth reference median5 -waist circumference ≥90th percentile2	Either: -a BMI ≥1 SD of the WHO growth reference median -visceral adiposity (measured by MRI) ≥90th percentile.
Normal weight with metabolic dysregulation	A normal weight (between −1 and +1 SD of the WHO reference median) and 2 or more of the following: -Plasma triglyceride ≥90th percentile -Systolic and/or Diastolic blood pressure ≥90th percentile -HDL-cholesterol <10th percentile -Triglyceride:HDL ratio ≥2.25	A normal weight (between −1 and +1 SD of the WHO reference median) and 2 or more of the following: -Plasma triglyceride ≥90th percentile -Systolic and/or Diastolic blood pressure ≥90th percentile -HDL-cholesterol <10th percentile -Triglyceride:HDL ratio ≥2.25
(Pre)diabetes mellitus type 2	According to international diagnostic criteria: Type 2 diabetes (at least 1 of 3): 1)Fasting serum glucose ≥126 mg/dL; 2)HbA1c ≥ 6.5%; or 3) Existing clinical diagnosis Prediabetes (at least 1 of 2) (ref): 1)Fasting serum glucose between 100 mg/dL and 12 mg/dL; 2)HbA1c ≥ 5.7% and <6.5%	Risk for prediabetes defined as: -≥90th percentile non-fasting serum glucose6

BMI: body mass index; DBP: diastolic blood pressure; HbA1c: hemoglobin A1c; HDL: high-density lipoprotein; MRI: magnetic resonance imaging; SD: standard deviation; WHO: World Health Organization.