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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Untargeted Serum Metabolomics Reveals Metabolic Disturbances in Children with MASLD: A Preliminary Study

2 more authors
6 affiliations
  1. 1Department of Clinical Biochemistry, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
  2. 2Metabolomics and Proteomics Laboratory, Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
  3. 3Department of Gastroenterology, Hepatology and Nutrition Disorders, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
  4. 4Department of Anthropology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
  5. 5Department of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
  6. 6Department of Medical Biochemistry, Medical University of Bialystok, 15-276 Bialystok, Poland

Abstract

Pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a major public health concern. The pediatric form of MASLD differs from the adult phenotype in its pathophysiology and exhibits distinct histopathological characteristics. This study aimed to characterize serum metabolomic alterations associated with pediatric MASLD and to identify metabolic signatures that may provide further insight into the disease phenotype. To this end, untargeted metabolomic analysis was performed on serum samples from 21 pediatric MASLD patients and 22 healthy controls using liquid chromatography coupled with high-resolution quadrupole time-of-flight mass spectrometry (LC-MS/QTOF). Univariate statistical analysis was performed using the Mann–Whitney U-test with false discovery rate (FDR) correction, while multivariate analysis employed principal component analysis and orthogonal partial least squares discriminant analysis (OPLS-DA). Multivariate analysis in the positive ionization mode demonstrated clear separation between the MASLD and control groups (R2Y = 0.972, Q2 = 0.823, CV-ANOVA p-value = 2.387 × 10−10). A total of 46 annotated metabolites differed significantly between the groups. The most pronounced alterations involved bile acid and sterol metabolism, including increased 12α-hydroxy-3-oxocholadienic acid and decreased conjugated primary bile acids, including taurine and glycine conjugates. In addition, increased levels of free carnitine and short-chain acylcarnitines, together with alterations in free and oxidized fatty acids, suggested disturbances in fatty acid metabolism. The metabolomic profile also revealed broad disruption of glycerophospholipid metabolism, characterized primarily by decreased lysophosphatidylcholines and lysophosphatidylethanolamines. In conclusion, the metabolomic profile of pediatric MASLD indicates pronounced systemic metabolic alterations, primarily involving lipid and fatty acid metabolism, bile acid and sterol metabolism, and amino acid-related pathways. The coordinated pattern of these changes suggests alterations across multiple interconnected metabolic processes, highlighting the complex metabolic phenotype of pediatric MASLD. The identified metabolic signatures provide a basis for further investigation and warrant validation in larger, independent cohorts to determine their biological and potential clinical relevance.

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BibTeX
@article{kowalskaciszek2026untargeted,
  title = {{Untargeted Serum Metabolomics Reveals Metabolic Disturbances in Children with MASLD: A Preliminary Study}},
  author = {Ewa Kowalska-Ciszek and Julia Zelkowska and Wojciech Jańczyk and Katarzyna Patla and Anna Siejka and Joanna Klimiuk-Balas and Magdalena Zielińska and Anna Świąder-Leśniak and Joanna Godzien and Dominik Cysewski and Agnieszka Ochocińska and Mieczysław Litwin and Michał Ciborowski and Piotr Socha},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = sep,
  doi = {10.3390/ijms27198742},
  url = {https://www.mdpi.com/1422-0067/27/19/8742},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Untargeted Serum Metabolomics Reveals Metabolic Disturbances in Children with MASLD: A Preliminary Study
AU  - Ewa Kowalska-Ciszek
AU  - Julia Zelkowska
AU  - Wojciech Jańczyk
AU  - Katarzyna Patla
AU  - Anna Siejka
AU  - Joanna Klimiuk-Balas
AU  - Magdalena Zielińska
AU  - Anna Świąder-Leśniak
AU  - Joanna Godzien
AU  - Dominik Cysewski
AU  - Agnieszka Ochocińska
AU  - Mieczysław Litwin
AU  - Michał Ciborowski
AU  - Piotr Socha
PY  - 2026
DA  - 2026/09/30
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27198742
UR  - https://www.mdpi.com/1422-0067/27/19/8742
AB  - Pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a major public health concern. The pediatric form of MASLD differs from the adult phenotype in its pathophysiology and exhibits distinct histopathological characteristics. This study aimed to characterize serum metabolomic alterations associated with pediatric MASLD and to identify metabolic signatures that may provide further insight into the disease phenotype. To this end, untargeted metabolomic analysis was performed on serum samples from 21 pediatric MASLD patients and 22 healthy controls using liquid chromatography coupled with high-resolution quadrupole time-of-flight mass spectrometry (LC-MS/QTOF). Univariate statistical analysis was performed using the Mann–Whitney U-test with false discovery rate (FDR) correction, while multivariate analysis employed principal component analysis and orthogonal partial least squares discriminant analysis (OPLS-DA). Multivariate analysis in the positive ionization mode demonstrated clear separation between the MASLD and control groups (R2Y = 0.972, Q2 = 0.823, CV-ANOVA p-value = 2.387 × 10−10). A total of 46 annotated metabolites differed significantly between the groups. The most pronounced alterations involved bile acid and sterol metabolism, including increased 12α-hydroxy-3-oxocholadienic acid and decreased conjugated primary bile acids, including taurine and glycine conjugates. In addition, increased levels of free carnitine and short-chain acylcarnitines, together with alterations in free and oxidized fatty acids, suggested disturbances in fatty acid metabolism. The metabolomic profile also revealed broad disruption of glycerophospholipid metabolism, characterized primarily by decreased lysophosphatidylcholines and lysophosphatidylethanolamines. In conclusion, the metabolomic profile of pediatric MASLD indicates pronounced systemic metabolic alterations, primarily involving lipid and fatty acid metabolism, bile acid and sterol metabolism, and amino acid-related pathways. The coordinated pattern of these changes suggests alterations across multiple interconnected metabolic processes, highlighting the complex metabolic phenotype of pediatric MASLD. The identified metabolic signatures provide a basis for further investigation and warrant validation in larger, independent cohorts to determine their biological and potential clinical relevance.
SN  - 1422-0067
ER  -