In adjusted analyses, some indices—such as fasting glucose, ALT, and diastolic blood pressure—did not reach statistical significance, possibly reflecting the limited intervention duration or the need for more intensive family-based components, consistent with Meng (2025) on NAFLD risk stratification in pediatric obesity 39 .
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A COM-B-guided lifestyle intervention reduces metabolic syndrome in overweight and obese adolescents: a multiphase study in Vietnam.
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