Interplay of childhood metabolic dysfunction-associated steatotic liver disease and obesity in the development of youth-onset type 2 diabetes

Table 1 Summary of quality assessment outcomes for included studies

Study type	Assessment tool	Number of studies	Quality scores/ratings	Key observations
Systematic reviews	PRISMA 2020	15	Mean score: 22/27 (range: 20-25)	Most adhered to PRISMA. Minor issues included unreported funding or protocols
Observational studies	Newcastle-Ottawa Scale	30	Mean score: 7.2/9 (range: 6-8)	Limitations included incomplete confounder adjustment and follow-up losses
Randomized controlled trials	Cochrane risk of bias 2	25	Low risk: 15, some concerns: 8, high risk: 2	High-risk studies had issues with randomization or missing data. Most had adequate blinding

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.