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. 2023 May;21(4):222-230.
doi: 10.1089/met.2023.0002. Epub 2023 Apr 20.

Association of Hepatic Steatosis with Adipose and Muscle Mass and Distribution in Children

Ghattas J Malki  1 , Nidhi P Goyal  1   2 , Patricia Ugalde-Nicalo  2 , Lauren F Chun  1 , Jasen Zhang  3 , Ziyi Ding  3 , Yingjia Wei  3 , Cynthia Knott  4 , Danielle Batakis  5 , Walter Henderson  5 , Claude B Sirlin  5 , Michael S Middleton  5 , Jeffrey B Schwimmer  1   2
Affiliations

Association of Hepatic Steatosis with Adipose and Muscle Mass and Distribution in Children

Ghattas J Malki et al. Metab Syndr Relat Disord. 2023 May.

Abstract

Background: Pediatric studies have shown associations between hepatic steatosis and total body fat, visceral fat, and lean mass. However, these associations have not been assessed simultaneously, leaving their relative importance unknown. Objective: To evaluate associations between hepatic steatosis and total-body adiposity, visceral adiposity, and lean mass in children. Method: In children at risk for fatty liver, hepatic steatosis, adipose, and lean mass were estimated with magnetic resonance imaging and dual-energy X-ray absorptiometry. Results: Two hundred twenty-seven children with mean age 12.1 years had mean percent body fat of 38.9% and mean liver fat of 8.4%. Liver fat was positively associated with total-body adiposity, visceral adiposity, and lean mass (P < 0.001), and negatively associated with lean mass percentage (P < 0.001). After weight adjustment, liver fat was only positively associated with measures of central adiposity (P < 0.001). Visceral adiposity also had the strongest association with liver fat (P < 0.001). Conclusions: In children, hepatic steatosis is more strongly associated with visceral adiposity than total adiposity, and the association of lean mass is not independent of weight or fat mass. These relationships may help guide the choice of future interventions to target hepatic steatosis.

Keywords: MRI-PDFF; adipose; hepatic steatosis; muscle; nonalcoholic fatty liver disease.

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Conflict of interest statement

C.B.S. reports grants to UCSD from American College of Radiology, GE, Siemens, Philips, Bayer, Foundation of NIH, Gilead, and Pfizer; personal consultation fees from Blade, Boehringer, and Epigenomics; consultation under the auspices of the University to AMRA, BMS, Exact Sciences, GE Digital, IBM-Watson, and Pfizer; laboratory service agreements to UCSD from Enanta, Gilead, ICON, Intercept, NuSirt, Shire, Synageva, and Takeda; royalties from Wolters Kluwer for educational material outside the submitted work; honoraria to the UCSD from Medscape for educational material outside the submitted work; pending position as Chief Medical Officer for Livivos; ownership of stock options in Livivos; and unpaid position in advisory board to Quantix Bio.

M.S.M. reports personal consultation fees from Alimentiv, Arrowhead, Glympse, Kowa, Median, and Novo Nordisk; laboratory services agreement through UCSD from Alexion, Astra Zeneca, Bristol-Myers Squibb, Celgene, Enanta, Galmed, Genzyme, Gilead, Intercept, Ionis, Janssen, NuSirt, Organovo, Pfizer, Roche, Sanofi, Shire, Synageva, Takeda, and Quantix Bio; grants to UCSD from Guerbet and Pfizer; personal fees from Livivos and Pfizer, outside the submitted work.

J.B.S. reports grants to UCSD from Intercept, Genfit, and Seraphina, outside the submitted work. All other authors have no conflicts of interest relevant to this article to disclose.

Figures

FIG. 1.
FIG. 1.
Study flow diagram showing the recruitment of participants in terms of screening, exclusion, and inclusion. DXA, dual-energy X-ray absorptiometry.
See this image and copyright information in PMC

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