NAFLD prevalence was assessed, and relationships of adipose-inflammatory factors with NAFLD activity score (NAS) and steatosis, activity, and fibrosis (SAF) score in MHO children with NAFLD were analyzed by Spearman's correlation analysis.<h4>Results</h4>Metabolic parameters and adipose-inflammatory factor levels (leptin, resistin, RBP-4, PGRN, TNF-α, IL-6, CCL2) were significantly higher in MHO than MHL, and further elevated in MUO, while adiponectin showed an inverse trend (all <i>P</i> < 0.05). Here, LEP is linked to metabolic dysfunction-associated steatotic liver disease.