Impact of nonalcoholic fatty liver disease severity on community-acquired pneumonia in children and adolescents aged 6 to 17 years: A retrospective CT-based study

This study aims to investigate the potential impact of nonalcoholic fatty liver disease (NAFLD) on the risk or severity of community-acquired pneumonia (CAP) in children and adolescents aged 6 to 17 years. Non-contrast chest computed tomography (CT) scans and laboratory data from patients aged 6 to 17 years with respiratory symptoms or fever between July and December 2023 were retrospectively analyzed. NAFLD and its severity were diagnosed based on a liver-spleen CT value ratio. The incidence and distribution of NAFLD across each age group were calculated. Abdominal circumference was measured using CT with specialized software. Chest CT scores quantified the severity of CAP, while inflammatory indices assessed positive C-reactive protein levels and white blood cell counts. Patients with NAFLD were assigned to the observation group, with non-NAFLD patients matched by age and sex served as the control group in a 1:1 ratio. One-way analysis of variance and independent sample rank-sum tests were used to analyze differences in chest CT scores, abdominal circumference, and inflammatory indices. Among 4740 eligible cases, the incidence of NAFLD increased with age, with an overall rate of 5.30%, and was more common in boys. The NAFLD group showed significantly higher abdominal circumference and inflammatory indices than those of the non-NAFLD group (P < .05). There were no significant intergroup differences in chest CT scores or sex (all P > .05). The chest CT score, proportion of males, and abdominal circumference were significantly higher in the moderate-to-severe NAFLD group than that in the mild NAFLD group (all P < .05). No significant intergroup differences were observed in age or inflammatory indices (all P > .05). Patients with moderate-to-severe NAFLD had higher chest CT scores than those with mild NAFLD. Moderate-to-severe NAFLD was associated with an increased risk or severity of CAP in children and adolescents aged 6 to 17 years.