Relationship of hepatic steatosis to adipose tissue distribution in pediatric nonalcoholic fatty liver disease.
OBJECTIVE
Central adiposity, a component of insulin resistance syndrome, is a risk factor for nonalcoholic fatty liver disease (NAFLD) in adults. To determine whether a similar relationship occurs in children, hepatic fat content and adipose tissue distribution were assessed in obese children at risk for NAFLD.


METHODS
We reviewed the charts of obese children undergoing evaluation for NAFLD because of hepatomegaly or elevated serum alanine aminotransferase (ALT) without obvious etiology. Hepatic fat fraction and adipose tissue distribution were obtained by rapid magnetic resonance imaging (MRI) techniques. Hepatic fat content was determined by a modification of the Dixon method that involves fast gradient echo. Body fat distribution was assessed by using heavily T1-weighted fast gradient echo technique on a single slice at the level of the umbilicus, and regions of interest were demarcated based upon pixel intensity threshold value including visceral adipose tissue (VAT) and subcutaneous adipose tissue content (SAT).


RESULTS
Ten children underwent hepatic MRI only. Twenty-nine children underwent hepatic and adipose tissue distribution MRI. There was a correlation between hepatic fat fraction and VAT (r = 0.37, P < 0.05) but not body mass index or SAT. Elevated serum ALT was associated with a higher hepatic fat fraction (P < 0.001) and VAT (P = 0.06).


CONCLUSIONS
Visceral adiposity is a risk factor for pediatric NAFLD.
Fishbein
Mark H
MH
Department of Pediatrics, Section of Gastroenterology, SIU School of Medicine, Springfield, Illinois 6270 1-1041, USA. mfishbein@siumed.edu
Mogren
Chris
C
Gleason
Theodore
T
Stevens
W Ross
WR
D050153:Abdominal Fat / Q000378:metabolism* / Q000473:pathology; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D005234:Fatty Liver / Q000209:etiology* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006529:Hepatomegaly / Q000378:metabolism / Q000473:pathology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism / Q000473:pathology; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D050507:Subcutaneous Fat, Abdominal / Q000378:metabolism / Q000473:pathology
D000410:Alanine Transaminase