Abstract Background This study aimed to evaluate the effectiveness of the tri‐ponderal mass index (TMI) in identifying metabolic dysfunction‐associated fatty liver disease (MAFLD) in obese children and adolescents. Methods A total of 238 obese children and adolescents were included in the study. Evaluations included anthropometric measurements, liver function tests, lipid parameters, fasting glucose, insulin, and HOMA‐IR. Logistic regression analysis was performed to determine the predictive value of TMI for MAFLD. Results MAFLD was diagnosed in 55.5% of participants. TMI values were significantly higher in the MAFLD group compared to those without MAFLD (mean TMI: 21.01 ± 3.05 vs. 20.14 ± 2.90, p = 0.026). In logistic regression analyses, male sex was an independent predictor in both models (OR = 3.10, p = 0.003 in the BMI‐SDS model; OR = 2.63, p = 0.008 in the TMI model). HOMA‐IR (OR = 1.10, p = 0.042; OR = 1.11, p = 0.029) and ALT (OR = 1.04, p = 0.002; OR = 1.05, p = 0.002) were also significant in both models. TMI was not independently associated with MAFLD ( p = 0.249). TMI showed positive correlations with age, weight‐SDS, BMI‐SDS, fasting insulin, HbA1c, HOMA‐IR, and the grade of hepatosteatosis. Conclusion While TMI values were higher in patients with MAFLD, TMI was not an independent predictor of MAFLD in obese children. Male sex, HOMA‐IR, and ALT were consistently associated with MAFLD, suggesting greater predictive value. These findings suggest that TMI may have limited utility as a screening tool for MAFLD in pediatric clinical practice.
Özer et al. (Wed,) studied this question.