Association Between High Myopia and Non-Alcoholic Fatty Liver Disease in Adolescents.

PURPOSE: To investigate the association between high myopia and non-alcoholic fatty liver disease (NAFLD) in adolescents and to explore potential metabolic mechanisms. METHODS: A total of 550 freshmen from Dali University were included. Data on refractive status, questionnaires, and serum metabolomics were collected. Multivariable logistic regression was used to assess the independent association between high myopia and NAFLD. Mediation analysis was performed to explore potential mediating metabolites, and enrichment analysis was utilized to explore key metabolic pathways. RESULTS: The prevalence of NAFLD in the study population was 11.3%. High myopia was associated with higher odds of NAFLD (OR = 2.81, 95% CI: 1.34-5.86). Mediation analysis suggested 15 metabolites as potential mediators, with L-phenylalanine (mediating effect: 23.0%) and L-leucine (mediating effect: 16.7%) showing the largest effects. Enrichment analysis revealed that these key metabolites were primarily enriched in pathways such as aromatic and branched-chain amino acid metabolism, lysine degradation, and pantothenate and CoA biosynthesis. CONCLUSION: High myopia was associated with increased odds of NAFLD in adolescents, and this relationship may be partially mediated by abnormalities in amino acid and energy metabolism, suggesting potential metabolic links between ocular and hepatic conditions.