Continuous Glucose Monitoring Metrics Are Associated With Metabolic Dysfunction–Associated Steatotic Liver Disease and Not Dysglycaemia in Adolescents With Obesity—A Pilot Study

INTRODUCTION: The clinical relevance of continuous glucose monitoring (CGM) metrics in adolescents with obesity remains uncertain, particularly in relation to obesity-related metabolic comorbidities. METHODS: In a pilot study, 39 adolescents with obesity (age 12.9 ± 2.9 years); 29 boys; mean body mass index standard deviation score (BMI SDS; 2.25 ± 0.58) underwent 15 days of CGM along with fasting plasma glucose, oral glucose tolerance testing (OGTT), glycated haemoglobin (HbA1c), and assessment of metabolic comorbidities. RESULTS: Adolescents with metabolic dysfunction-associated steatotic liver disease (MASLD; n = 5, 12.8%) demonstrated higher median mean amplitude of glycaemic excursion (MAGE; 42.4 vs. 35.2 mg/dL; p = 0.019) and mean of daily difference (MODD; 23.3 vs. 18.5 mg/dL; p = 0.062) compared with those without it. BMI SDS correlated positively with glucose management indicator (GMI; ρ = 0.34, p = 0.041), mean glucose (ρ = 0.34, p = 0.041), and continuous overall net glycaemic action (CONGA; ρ = 0.38, p = 0.022), whereas fasting glucose, 2-h OGTT glucose, and HbA1c showed no associations. CONCLUSIONS: In adolescents with obesity, CGM-derived glycaemic variability metrics were associated with adiposity and MASLD, whereas conventional laboratory measures were not. These findings suggest that CGM may provide complementary information for metabolic phenotyping in paediatric obesity. Longitudinal studies are required to determine implications.