Tricò D, et al. - A prospective study was conducted in a large, multiethnic cohort of obese adolescents to describe clinical and genetic features related to the pediatric nonalcoholic fatty liver (NAFL), the most common cause of chronic liver disease in youth. Study participants were 503 obese adolescents, including 191 (38.0%) whites, 134 (26.6%) blacks, and 178 (35.4%) Hispanics. Findings revealed that black obese adolescents are relatively protected from liver steatosis, however, are more susceptible to the deleterious effects of NAFL on glucose metabolism. For developing NAFL, the combination of ethnicity/race with markers of insulin resistance and genetic factors might help identify obese youth at risk. White or Hispanic ethnicity, high fasting C-peptide levels, and weight gain were risk factors for NAFL incidence. On the other hand, baseline hepatic fat fraction (HFF) and weight loss anticipated resolution of NAFL at follow-up.