Furthermore, in the multivariate analysis, hepatic necroinflammation was still an independent factor associated with the severity of hepatic fibrosis after adjusting for age, gender, BMI z-score, CBI, hemoglobin, Prealbumin, total bilirubin (TBil), alkaline phosphatase (ALP), total bile acid (TBA), creatinine, amylase, urid acid, AST, the grade of necroinflammation and the degree of steatosis in NAFLD children (OR 4.504, 95%CI 2.045–9.920). Here, TTR is linked to steatosis.